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Kidney Week

Abstract: PO0775

Geographic Variations in Healthcare Resource Utilization (HRU) and Costs and Their Associations with Albuminuria Testing in Patients with CKD and Type 2 Diabetes (T2D)

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Singh, Rakesh, Bayer U.S. LLC, Whippany, New Jersey, United States
  • Betts, Keith A., Analysis Group Inc, Los Angeles, California, United States
  • Song, Jinlin, Analysis Group Inc, Los Angeles, California, United States
  • Wang, Yao, Analysis Group Inc, Los Angeles, California, United States
  • Elliott, Jay, Bayer U.S. LLC, Whippany, New Jersey, United States
  • Warnock, Neil, Bayer U.S. LLC, Whippany, New Jersey, United States
  • Farej, Ryan, Bayer U.S. LLC, Whippany, New Jersey, United States
Background

Albuminuria monitoring is critical for CKD management. The study evaluated the geographical urine albumin-to-creatinine ratio (UACR) monitoring patterns in the US along with the associated economic outcomes in patients with CKD and T2D.

Methods

Adult patients with T2D and CKD were identified from the Optum Clinformatics® claims data (Jan 2015-Dec 2019). HRU, healthcare costs (in 2020 USD), and percentage of patients receiving at least one UACR test were summarized by state during the one-year after T2D and CKD diagnoses. Patients who had dialysis or kidney transplantation before or during the study period were excluded.

Results

Among the 101,057 patients with T2D and CKD, the average annual healthcare costs were $28,636 and increased with CKD severity, from $20,122 (stage I, n = 4,070) to $38,072 (stage V, n = 242). Large variation exists across states ranging from $21,003 [HI] to $35,995 [IL] (Figure 1a). The average number of inpatient visits (range: 0.3 [AZ] to 0.7 [AR]), outpatient visits (18.3 [CO] to 29.8 [CT]), and emergency room visits (0.4 [MI] to 1.0 [KS]) also varied substantially. The average UACR testing rate was 38.7%, consistently low across states (14.0% [ME] to 58.9% [HI]). States with lower UACR testing rates tended to have higher healthcare costs (Figure 1b).

Conclusion

Patients with CKD and T2D had high HRU and healthcare costs with large variations across states. Lower UACR testing rates were associated with higher economic burden.

Funding

  • Commercial Support