Abstract: FR-PO787
Correspondence Between Causes of Recurrent Hospitalizations Among Hemodialysis Patients
Session Information
- Dialysis: Hospitalization and Mortality
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sibbel, Scott, DaVita Clinical Research, Minneapolis, Minnesota, United States
- Walker, Adam G., DaVita Clinical Research, Minneapolis, Minnesota, United States
- Tentori, Francesca, DaVita Clinical Research, Minneapolis, Minnesota, United States
- Brunelli, Steven M., DaVita Clinical Research, Minneapolis, Minnesota, United States
Background
Despite targeted efforts, hospitalizations represent a major burden for end-stage kidney disease patients, with an average of 1.7 admissions per patient-year and 30.7% of patients being readmitted to the hospital. There is a need to identify factors that drive hospitalization risk in this population. We evaluated cause of initial admission and readmission among patients receiving in-center hemodialysis at a large dialysis organization (LDO) in the US.
Methods
Using Medicare claims we identified all patients with at least one index hospitalization ≥ 1 day during 2014. Readmissions were defined as hospitalizations that occurred within 30 days after index admission. Cause of hospitalizations were determined by primary ICD-9 diagnosis code and were classified using the clinical classification system (CCS). The relationship between causes of index hospitalization and readmission were determined through cross-tabulation of the percent difference between observed (O) and expected (E) readmissions accounting for background admission rate (O-E/E*100).
Results
During the study period the overall probability of readmission was 31.5%. Diseases of the circulatory system were the most common cause for both hospitalizations and readmissions. Overall, the probability of readmissions did not vary greatly by cause of index admission (28.8%-35.8%) and the leading cause of readmission was the same as that of the index hospitalization.
Conclusion
We found that the cause of readmission was closely related to the cause of prior hospitalization in a large sample of US dialysis patients. Despite potential misclassification of readmission cause, these results raise the possibility that the clinical issue was not fully addressed during the index admission. Further studies are needed to identify clinical practices that may help reduce readmission rates.
Funding
- Commercial Support – DaVita Inc