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Kidney Week

Abstract: PO1230

Inpatient Dialysis Provider Type and Duration of Hospital Admissions of Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Morrison, Joshua Wayne, DaVita Inc, Denver, Colorado, United States
  • Liu, Daniel, DaVita Inc, Denver, Colorado, United States
  • Mahoney, David L., DaVita Inc, Denver, Colorado, United States
  • Giullian, Jeffrey A., DaVita Inc, Denver, Colorado, United States
Background

Inpatient dialysis treatments may be performed by hospital staff or by a contracted dialysis provider. In this study, we compared duration of hospitalizations of dialysis patients who were admitted to hospitals performing in-house dialysis to that of patients who were admitted to hospitals contracting with a dialysis provider.

Methods

Data for this analysis were derived from the electronic medical records of a large dialysis organization. We identified patients who were hospitalized between Jan 2017 and Sept 2019. Length of stay was compared for patients who were admitted to hospitals performing dialysis in-house versus patients who were admitted to hospitals that contracted with the dialysis organization.

Results

During the study period, we identified 155,458 hospitalizations among 64,662 patients at 572 hospitals in which dialysis was performed by in-house staff. There were 226,059 hospitalizations among 87,213 patients at 797 hospitals in which dialysis was performed by the dialysis organization. There were no meaningful differences in patient characteristics or reasons for admission among patients admitted to hospitals performing dialysis in-house compared to those of patients admitted to hospitals contracting with the dialysis organization. The mean length of stay for patients admitted to hospitals providing dialysis in-house was 6.0 days versus 5.7 days for patients admitted to hospitals contracting with the dialysis organization, a difference of 5.0%. We made similar observations for hospitals with ≤400 beds, hospitals that were not affiliated with an academic medical center, and hospitals designated trauma levels II to V. These differences were attenuated at hospitals with >400 beds, academic medical centers, and level I trauma hospitals.

Conclusion

These results suggest that use of a contracted dialysis organization may shorten the length of stay for patients who require dialysis during hospital admissions and this trend was more pronounced in smaller, non–university-affiliated hospitals.