Abstract: TH-PO526

Sex Differences in Progression and Resource Utilization in CKD

Session Information

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 GenderFemaleMaleTotal
Number of patients1,92518,14613,25733,328
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