Abstract: SA-PO874
Inpatient Admissions Account for the High Medical Costs of CKD
Session Information
- CKD: Pharmacoepidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Nichols, Gregory A., Kaiser Permanente Northwest, Portland, Oregon, United States
- Ustyugova, Anastasia, Boehringer Ingelheim International GmbH, Ingelheim, Germany
- Deruaz-Luyet, Anouk, Boehringer Ingelheim International GmbH, Ingelheim, Germany
- Brodovicz, Kimberly, Boehringer Ingelheim, Ridgefield, Connecticut, United States
Background
Chronic kidney disease (CKD) results in high medical costs typically attributed to renal dialysis but excess costs begin to accumulate in earlier CKD stages. Better understanding of medical costs and its determinants may help to optimize patient care in resource-constrained settings. We evaluated annual medical costs in patients with CKD across types of care and in subgroups of patients with and without diabetes, cardiovascular disease, and heart failure.
Methods
We used the electronic medical records of Kaiser Permanente Northwest to identify 21,252 patients with CKD in 2016 or 2017 and examined non-mutually exclusive groups according to presence of comorbidities. We used 1 year of follow-up data to calculate the annual outpatient, inpatient, emergency, pharmaceutical, dialysis, and total medical care costs by KDIGO-defined stages of CKD adjusted for age, sex, non-white race, and within subgroups of patients with selected comorbidities.
Results
Inpatient costs accounted for 42%, 50%, 57% and 29% of total costs for stages G3a, G3b, G4, and G5, respectively (figure). Nearly 30% of all hospitalizations were CVD-related. Patients with CKD and 1 or more comorbidities incurred 2.4 to 4-fold greater medical costs than those with no comorbidities. Inpatient costs accounted for 35%-66% of the total in stages G3a, G3b and G4, and 23%-37% in stage G5.
Conclusion
Inpatient costs consistently accounted for over 40% of the total costs of care for CKD patients prior to reaching end-stage kidney disease regardless of the presence of comorbidities. Considering the significant economic burden evident in early CKD stages, development and implementation of effective measures to reduce the need for inpatient care is critical.
Funding
- Commercial Support – Boehringer Ingelheim