Intervention helped involuntary discharged patients on hemodialysis regain access to care
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Key takeaways:
- Overall, nine patients were successfully placed in a second chance hemodialysis program.
- Data showed six patients had a reduction in hospital admissions.
SAN DIEGO — A quality improvement project among a predominately Black urban population helped patients on hemodialysis who were involuntary discharged regain access to care, according to presented data.
The study was conducted at Emory Hospitals and Grady Memorial Hospital in Atlanta among 30 adults with end-stage kidney disease who were involuntarily discharged from a hemodialysis center, as well as those who started hemodialysis as inpatients.
Overall, nine patients were successfully placed in a second chance hemodialysis program.
Siddartha Bhandary, MD, of Emory University presented the data at ASN Kidney Week.
Mean age of the cohort was 49.8 years, 70% were men and 77% had Medicaid. All patients were Black.
The retrospective study ran from January 2020 to March 2024, with the intervention period lasting between May 2023 and September 2023. The aim was to assess clinical characteristics of the cohort and the success of a second chance dialysis program.
The most common discharge reasons were noncompliance and disruptive behavior, according to the researchers. Of the cohort, 37% patients had documented substance abuse and 40% had psychiatric disorders. In addition, six patients had HIV and six were homeless.
Overall, 16 patients were successfully placed in a second chance hemodialysis program before the quality improvement project and nine more patients were added after implementation.
Bhandary and colleagues found six of the newly added nine patients had a reduction in hospital admissions, with one outlier accounting for 43% of the admissions in the study. Patients had 52 prior admissions for hemodialysis and five admissions afterward.
Discharge in patients with kidney disease “should always be preceded by thorough documentation and intervention,” Bhandary said in the presentation. “Dialysis patients [may] go through emotional, financial and physical burden, so this might relate to behavioral issues and discharge, so we encourage this topic to be further explored.”
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