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Kidney Week

Abstract: PO0495

Patterns of Hospital Admissions Among Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Gray, Kathryn S., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Cohen, Dena E., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
Background

Although chronic kidney disease (CKD) is relatively common in the United States, an understanding of the frequency, causes, and costs of hospital admissions among patients with CKD at the national level is lacking.

Methods

Study data were derived from the Centers for Medicare & Medicaid Services 100% claims sample (2017-2018). Included patients were adults enrolled in Medicare Parts A and B who had a claim including a diagnosis code for CKD stage 3, 4, or 5 during 2017; exposure was ascribed as the most severe observed stage. Patients with evidence of commercial insurance, diagnosis of end-stage kidney disease, dialysis treatment, or death, prior to 31 Dec 2017 were excluded. Hospital admissions and paid costs were considered from 01 Jan 2018 through the first of 31 Dec 2018 or censoring for loss of Medicare Part A, dialysis initiation, or death. Hospitalization causes were ascribed on the basis of ICD-10 codes, grouped using Clinical Classification Software Level 1 categories.

Results

A total of 1,352,401 patients with CKD3, 208,963 patients with CKD4, and 16,159 patients with CKD5 met eligibility criteria. Annual hospitalization rates were 0.66, 0.87, and 0.77 admissions/patient-year among patients with each CKD stage, respectively. Across all 3 stages, admissions for “Diseases of the Circulatory System” accounted for approximately 25% of hospitalizations, with “hypertension with complications and secondary hypertension” contributing approximately half of the hospitalizations in this category. Considerable regional variation was observed with respect to annual hospitalization costs among this population, with the Southwest, Northeast, and Mid-Atlantic regions tending to have higher costs than other parts of the country.

Conclusion

Patients with CKD are frequently hospitalized, with associated costs that display marked regional variation. Clinically and regionally targeted programs may result in improved patient outcomes and lower health care costs.