Abstract: FR-PO653
Long-Term Healthcare Cost and Resource Use in Patients with Hyperkalemia
Session Information
- Fluid and Electrolytes: Clinical - Potassium, Sodium, Water
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid and Electrolytes
- 902 Fluid and Electrolytes: Clinical
Authors
- Kanda, Eiichiro, Kawasaki Medical School, Kurashiki, Okayama, Japan
- Kashihara, Naoki, Kawasaki Medical School, Kurashiki, Okayama, Japan
- Kohsaka, Shun, Keio University, Tokyo, Japan
- Okami, Suguru, Astrazeneca, Tokyo, Japan
- Yajima, Toshitaka, Astrazeneca, Tokyo, Japan
Background
Few studies provide information on economic burden of hyperkalemia (HK) especially regarding long-term healthcare cost and resource use.
Methods
A retrospective cohort study was done with a Japanese hospital claims database, Medical Data Vision. We extracted data for patients aged ≥18 years with ≥2 serum potassium (S-K) values ≥5.1 mmol/L; from April 1, 2008, to September 30, 2018 for patients with HK, and normokalemic patients without any record of S-K ≤3.5 mmol/L or ≥5.1 mmol/L. Direct healthcare cost and resource use over 1 year after the first HK episode and during follow-up after 1 year were separately assessed.
Results
27,534 HK cases and 233,098 normokalemic controls were identified from a total of 1,208,894 patients who had at least one S-K value. Mean length of follow-up was 2.90 years in cases and 3.68 years in controls. Compared with controls, median inpatient and outpatient costs per visit over 1 year were significantly higher in HK (inpatient: $6,614 vs. $4,046; outpatient: $231 vs. $116) (p <0.001) and after 1 year (inpatient: $6,072 vs. $4,042; outpatient $253 vs. $130) (p <0.001). Median total costs in HK and controls were $7,617 (interquartile range [IQR] $3,119-$19,733) and $938 (IQR $345-$2,359) over 1 year, and $4,335 (IQR $1468-$1,1620) and $779 (IQR $269-$2,079) after 1 year, respectively. Median total costs were higher in subgroups of heart failure ($11,147) and chronic kidney disease ($8,407) (Figure). HK cases had higher resource use including incidences of hospitalization (62.6% vs. 14.4%), rehospitalization (10.0% vs. 1.1%), and emergency room (ER) visit (26.9% vs. 3.2%) over 1 year. Higher resource use continued after 1 year with cumulative incidences of hospitalization (73.7% vs. 49.7%), rehospitalization (29.3% vs. 7.3%), and ER visit (50.4% vs. 16.3%). HK cases had longer hospital stay (mean 22.97 days vs. 11.05 over 1 year, and 21.06 vs. 10.94 days after 1 year).
Conclusion
The results showed that HK is associated with significant long-term economic burden and needs careful medical attention.
Mean cumulative cost over 12 months after hyperkalemia
Funding
- Commercial Support –