Abstract: TH-PO810
Employment among Patients Starting Dialysis in the United States
Session Information
- Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular
Authors
- Erickson, Kevin F., Baylor College of Medicine, Bellaire, Texas, United States
- Zhao, Bo, Baylor College of Medicine, Bellaire, Texas, United States
- Ho, Vivian, Baker Institute for Public Policy, Houston, Texas, United States
- Winkelmayer, Wolfgang C., Baylor College of Medicine, Bellaire, Texas, United States
Background
Patients with end-stage renal disease (ESRD) face significant challenges to remaining employed, and the rate of employment among the prevalent population of patients receiving dialysis is low. It is unknown when in the course of their kidney disease patients stop working. We examined employment trends among patients in the United States who are initiating dialysis and in the six months prior to ESRD.
Methods
We selected patients aged 18-54 who initiated dialysis between 1996 and 2013 from a U.S. registry of patients with ESRD. We compared unadjusted trends in employment at the start of dialysis and six months prior to ESRD, and used linear probability models to estimate changes in employment over time after adjusting for patient health, demographic and socioeconomic characteristics along with local unemployment rates in the general population. We also examined employment among selected vulnerable patient populations.
Results
Employment was low among patients starting dialysis throughout the study period at 22%-23%. However, after adjusting for observed characteristics, the probability of employment increased over time; patients starting dialysis between 2008 and 2013 had a 3.6% (95% CI 3.2%-4.0%) increase in the absolute probability of employment at the start of dialysis compared to patients starting dialysis between 1996 and 2001. More than 30% of patients who were employed six months prior to ESRD stopped working by dialysis initiation, but the adjusted probabilities of employment six months prior to ESRD and of remaining employed among those employed six months prior increased during the study period by 5.5% (95% CI 5.1%-5.9%) and 4.6% (95% CI 3.9%-5.3%), respectively. Black and Hispanic patients were less likely to be employed than other patients starting dialysis, but this gap narrowed during the study period.
Conclusion
Although working-aged patients starting dialysis between 1996 and 2013 experienced increases in the adjusted probability of employment over time, rates of employment remained low. Efforts to help patients with ESRD remain employed should target patients approaching ESRD as well as those already on dialysis.
Funding
- NIDDK Support