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Abstract: TH-PO303

Employment 6 Months Prior to and at Dialysis Start: Validation Evidence for CMS-2728 Data

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Kutner, Nancy G., Emory University School of Medicine, Atlanta, Georgia, United States
  • Zhang, Rebecca H., Emory University, Atlanta, Georgia, United States

The CMS-2728 is a unique source of patient employment status 6 months prior and at dialysis start. A USRDS analysis of patients 18-54 initiating in-center hemodialysis (HD) or home dialysis 1996-2013 showed a persistent pattern of job loss in the 6-month pre-dialysis interval (CJASN 2018). The CMS-2728 employment field has not been independently validated, however. We compared incident patients’ interview responses obtained approximately 2 months after dialysis start with corresponding employment information from their CMS-2728 report.


Patients who began in-center HD or home dialysis July 1996-August 1997, English- or Spanish-speaking and without documented cognitive impairment, were recruited for a study of health behaviors/quality of life from 26 dialysis clinics serving the Atlanta GA 23-county area. Participants represented eligible patients in age, race and functional status but the cohort included fewer women. Structured in-person interviews were conducted at a non-dialysis facility location convenient for the patient 67.3 + 19.5 days after dialysis start. 95/226 study participants were ages 20-54 (median 43) with women 47%; blacks 58%; non-Hispanic whites 35%; and Hispanic, Asian, other 7%. CMS-2728 employment status options include: unemployed, employed full time (FT), employed part time (PT), homemaker, retired (age/preference), retired (disability), medical leave of absence, and student. The patient interview asked: Are you working now (hours/week)? job being held? retired or stopped working; when? keeping house? student (FT, PT)? Using FT, PT, or student to define employment (CJASN 2018), we identified the unadjusted proportion of patients employed 6 months prior and at dialysis start, reported by the CMS-2728 and by patients.


Compared with their CMS-2728 data, 8% more patients reported being employed 6 months prior, while 6% fewer patients reported current employment. Potential job maintenance opportunities were suggested by patients who reported having switched from FT to PT work, said their prior job was “being held,” cited a medical leave of absence, or reported being “let go” from their job (in all, 14% of the cohort).


Our study suggests that CMS-2728 employment fields have good validity. Effective interventions are needed to help patients remain in the workforce as they transition to dialysis.


  • NIDDK Support