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Abstract: FR-PO794

Determinants of Dialysis Facility Hospital Readmissions

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Ashkar, Ziad Maurice, Lafayette General Health, Lafayette, Louisiana, United States
Background


Hospital readmissions are common, costly, and potentially avoidable . In ESRD, factors including anemia, CHF, cardiovascular disease, malignany, vascular access and low albumin were associated with readmissions. No studies have looked into dialysis units specific determinants of dialysis facility readmission rate. The purpose of this study is to identify unique dialysis facility determinants of hospital readmissions.

Methods

Observational retrospective, cross-sectional design. Data are obtained from CMS Dialysis Facility Compare, release date April 2018. Dialysis facility readmission rate was used as outcome variable. ( defined as a percentage of hospital discharges). Multilinear regression with cluster by network was then done, with number of dialysis stations, % of patients with hemoglobin<10g/dl, % with KT/V>=1.2, % with AV Fistula in use, % with catheters more than 90 days, % with Calcium > 10.2mg/dl, phosphorus < 3.5 mg/dl and >7mg/dl

Results

For each increase in number of dialysis stations, there is a 6.3 % increase in dialysis facility readmission rate (DFR) . For each increase in % patients with Hb < 10g/dl , there is a 3.8 % increase in DFR. Each increase in % with KT/V>=1.2 is associated with 13.5 % decrease in DFR. There are no associations with the other variables.

Conclusion

Using data from dialysis facility compare, hemodialysis clinics with KT/V>=1.2 are associated with significant decrease in dialysis facility readmission rates. Increase in dialysis stations and increase in percent with hemoglobin < 10g/dl are associated with increase in readmission rates. Strategies targeting adequate clearance and anemia management will likely have significant impacts towards decreasing hospital readmissions in individual dialysis facilities . More studies are needed to understand drivers behind increase in station numbers and readmissions in dialysis.

Multilinear regression determining Dialysis Facility Readmission Rate.
 coefficientp value
Dialysis stations0.06280.008*
% Hb<100.0380.002*
%KT/V>=1.2-0.1350.014*
%AV fistula in use-0.0350.112
%catheter>90 days0.0320.24
%Ca>10.2-0.030.779
%Ph<3.50.060.103
%Ph>7-0.0060.819