Abstract: SA-PO432
Post-Discharge Economic Burden of Hyperkalemia-Related Hospitalizations
Session Information
- CKD: Epidemiology, Outcomes - Non-Cardiovascular - II
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular
Authors
- Betts, Keith, Analysis Group, Inc., Boston, Massachusetts, United States
- Woolley, J. Michael, ZS Pharma Inc., San Mateo, California, United States
- Mu, Fan, Analysis Group, Inc., Boston, Massachusetts, United States
- Kelkar, Sneha S, Analysis Group, Inc., Boston, Massachusetts, United States
- Xiang, Cheryl Q., Analysis Group, Inc., Boston, Massachusetts, United States
- Wang, Yao, Analysis Group, Inc., Boston, Massachusetts, United States
- Wu, Eric, Analysis Group, Inc., Boston, Massachusetts, United States
Background
The objective of this study was to estimate healthcare resource use and costs post hyperkalemia-related hospitalization discharge.
Methods
Adults with potassium lab results available were selected from a large US commercial claims database (1/1/2010-12/31/2014). Patients with at least one hospitalization with a hyperkalemia diagnosis (ICD-9 276.7) during the inpatient stay were selected as cases. Patients with at least one hospitalization and with normal potassium lab results (≤5.0 mEq/L), no hyperkalemia diagnoses, and no sodium polystyrene sulfonate prescriptions were selected as controls. The first hyperkalemia-related hospitalization was defined as the index hospitalization for cases and a randomly selected eligible hospitalization was identified as the index hospitalization for controls. Continuous enrollment from 6 months prior to index hospitalization admission (baseline period) to 12 months post discharge (study period) was required. The day after index hospitalization discharge was defined as the index date. Controls were matched 1:1 to cases exactly on age group, chronic kidney disease (CKD) stage, receiving dialysis, heart failure, Renin-Angiotensin-Aldosterone-System inhibitor use, major diagnostic categories, and selected diagnosis-related groups. Resource use and total costs (2016 USD) were compared between cases and controls.
Results
A total of 4,418 matched cases and controls were included in the analysis. Cases had higher rates of inpatient admissions (1.00 vs. 0.41), emergency department visits (1.98 vs. 1.13), and outpatient visits (49.60 vs. 38.93) compared to controls in the 1-year study period (all p<0.001). Cases incurred $33,120 higher 1-year total all-cause costs ($71,322 vs. $38,203), and higher costs within each quarter (Q1: $23,615 vs. $12,041; Q2: $16,466 vs. $9,241; Q3: $16,630 vs. $8,560; Q4: $14,611 vs. $8,361) compared to controls (all p<0.001). Among patients with CKD and/or heart failure, cases had $33,827 higher 1-year total costs than controls ($76,971 vs. $43,143; p<0.001).
Conclusion
The results indicate that hyperkalemia-related hospitalizations are associated with significant economic burden during the 1-year post-discharge period.