Abstract: TH-PO526
Sex Differences in Progression and Resource Utilization in CKD
Session Information
- CKD: Health Services, Disparities, Prevention
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 307 CKD: Health Services, Disparities, Prevention
Authors
- Arora, Pradeep, University at Buffalo, Buffalo, New York, United States
- Anand, Edwin J., University at Buffalo, Buffalo, New York, United States
- Eberle, Joseph A., Intelligent Care Management, East Amherst, New York, United States
- Jalal, Kabir, University at Buffalo , Hamburg, New York, United States
- Venuto, Rocco C., University at Buffalo, Buffalo, New York, United States
Background
Prevalence of CKD in early stages is higher among females than males, in contrast more males develop ESRD. Resource utilization between sexes is not well studied. We hypothesized that resource utilization is greater among males when compared to females.
Methods
Data from a large third party payer, with an enrollment of 1.4 million, from 2007-14. CKD was defined as GFR less than 60 ml/min/1.73 BSA for more than three months. Data analyzed included demographics, comorbid conditions (CAD, CHF, PVD, COPD, depression, cancer, diabetes, and hypertension), hospitalization and cost of care. Univariate and multivariate analyses of the predictive variables were undertaken. Chi squared test was used to compare the proportions of clinical variables among the sexes.
Results
33,328 CKD cases were identified. There were 18,146 females, 13, 257 males, 1,925 sex non specified. The proportion of CKD was higher in females compared to males (54 % vs 40 %, 6% unknown).CKD stages 3, 4 and 5 were found in respectively 51% , 54%, and 50% compared to 47%, 45%, and 48% in males. Female CKD patients had higher prevalence of comorbidities. Annual hospitalization rates were 2.26 for females and 2.35 for males. Cost/patient-year was higher in males $12,000 vs $10,426,which was statistically significant. Progression to renal replacement therapy revealed a shift to a male dominance (57% vs 43%). More males received renal transplantation (56% vs 42%)
Conclusion
The total per patient cost was higher for males in CKD 3-5. Males more often progressed to ESRD. The results of predictive modeling will be included.
Unknown Gender | Female | Male | Total | |
Number of patients | 1,925 | 18,146 | 13,257 | 33,328 |
Total costs | $ 17,087,129 | $ 189,196,152 | $ 159,167,515 | $ 365,450,797 |
Total drug costs | $ 5,353,367 | $ 36,042,849 | $ 30,295,035 | $ 71,691,251 |
Professional Fees | $ 4,608,269 | $ 49,624,616 | $ 38,755,082 | $ 92,987,967 |
Hospital Costs | $ 6,426,096 | $ 77,916,991 | $ 73,052,148 | $ 157,395,236 |
Hospice | $ 2,784 | $179,365 | $ 137,650 | $ 319,799 |
Outpatient costs | $ 104,303 | $ 5,464,626 | $ 6,488,736 | $ 12,057,665 |
Home health costs | $ 254 | $ 20,421 | $ 11,316 | $ 31,992 |
Skilled nursing facility | $ 222,472 | $ 10,217,411 | $ 5,030,576 | $ 15,470,459 |
Specialty facility | $ 133,033 | $ 1,283,666 | $ 885,179 | $ 2,301,878 |
Miscellaneous | $ 236,550 | $ 8,445,722 | $ 4,511,655 | $ 13,193,927 |
Reserved amount | $0 | $ 485 | $ 138 | $ 623 |
Religious non med amount | $0 | $0 | $0 | $0 |
Total Medical Amount | $11,733,762 | $ 153,153,303 | $ 128,872,481 | $293,759,546 |
Funding
- Private Foundation Support