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Abstract: FR-PO790

Recent Trends in Hospital Admissions Among Medicare Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ray, Debabrata, NxStage Medical, Inc., Victoria, Minnesota, United States
  • Kubisiak, Kristine, NxStage Medical, Inc., Victoria, Minnesota, United States
  • Collins, Allan J., NxStage Medical, Inc., Victoria, Minnesota, United States
  • Weinhandl, Eric D., NxStage Medical, Inc., Victoria, Minnesota, United States
Background

Hospital admissions not only reflect the morbidity of dialysis patients, but also account for more than one-third of Medicare Parts A and B expenditures among patients (USRDS Annual Data Report, 2017). We assessed trends in hospital admissions among Medicare dialysis patients in 2014-2016.

Methods

We analyzed Medicare limited data sets. For each calendar week (Monday to Sunday) in 2014-2016, we identified all Medicare Parts A and B beneficiaries with ≥1 outpatient dialysis treatment. We excluded patients hospitalized on Sunday and not discharged before the end of the day. We calculated the percentage of patients with ≥1 hospital admission during the next week. We fit an ARIMA(1,0,0)x(0,1,0) model to the time series of admission percentages and used a likelihood ratio test to assess whether a secular trend remained after accounting for serial correlation and seasonality. We analyzed the aggregate population and strata defined by age, race, sex, concurrent Medicaid enrollment, US Census Division, and dialytic modality (hemodialysis, peritoneal dialysis).

Results

The average number of Medicare dialysis patients per week was over 286,000. As displayed in the figure, the mean percentage of dialysis patients who were newly hospitalized each week was 3.09% in 2014, 3.07% in 2015, and 3.10% in 2016 (P = 0.90, from test of secular trend). This percentage increased significantly (P < 0.05) among ages 20-34 years (3.47%, 3.58%, and 3.70% in 2014, 2015, and 2016, respectively), ages 35-44 years (2.93%, 2.98%, and 3.09%), Medicaid enrollees (3.33%, 3.33%, and 3.39%), and West South Central residents (2.91%, 2.92%, 3.00%). In other strata, secular trends were not significant (P > 0.05).

Conclusion

Between 2014 and 2016, the risk of hospital admission among all Medicare dialysis patients was stable, although a secular trend of increasing risk was evident in young adult and dual-eligible patients.

Funding

  • Commercial Support