Abstract: TH-PO708
Association Between Renal Disease Management and Hospital Care Utilization
Session Information
- Diversity and Equity in Kidney Health - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Dhawan, Rahul, Optum Inc, Eden Prairie, Minnesota, United States
- Crossman, Ashley, Optum Inc, Eden Prairie, Minnesota, United States
- Wysocky, Gregory, Optum Inc, Eden Prairie, Minnesota, United States
- Moran, Karen, Optum Inc, Eden Prairie, Minnesota, United States
- Keers, Grace, Optum Inc, Eden Prairie, Minnesota, United States
- Plosser, Kevin, Optum Inc, Eden Prairie, Minnesota, United States
- Tao, Jiang, Optum Inc, Eden Prairie, Minnesota, United States
- Benusa, Elizabeth, Optum Inc, Eden Prairie, Minnesota, United States
Group or Team Name
- Optum KRS nurses and product team and the OHS Medical Office Team
Background
Evidence about impacts of disease management programs among patients with advanced stages of chronic kidney disease (CKD) is still limited. The study objectives were to evaluate the association between a renal disease management program which focuses on permanent access placement, home based dialysis initiation and patient education and hospital care utilization among patients with advanced CKD.
Methods
A case-control study was performed. The treatment group contained CKD 4-5 and ESRD health plan members in Utah with access to the renal care management program (N =25,332 member months). The control group contain CKD 4-5 and ESRD health plan members in Nevada without access to the renal care management program (N = 36,225 member months). Data sources included medical claims and lab result data. Inverse propensity score weighting (IPSW), based on confounding factors such as age, gender, prevalent comorbidities and CKD stages, was employed to reduce selection bias. Changes in hospital admissions and length of hospital stay (LOS) were compared to evaluate the impacts of the program.
Results
Generalized linear models with IPSW showed hospital admissions among the treatment group with ESRD declined by 32 per 1,000 patients per month from 2017-2018 while hospital admissions in the control group with ESRD increased by 36 per 1,000 patients per month during the same period (P<0.01). Changes in LOS between the treatment and control groups with ESRD showed the same pattern but were not statistically significant (P=0.09). Among members with CKD 4/5, hospital admissions among the treatment group increased by 4 admissions per 1,000 patients per month while hospital admissions in the control group increased by 6 admissions per 1,000 patients per month during the same period, but this difference was not significant (P=0.71). Changes in LOS between the treatment and control groups with CKD showed the same pattern but were also not statistically significant (P=0.93).
Conclusion
A disease specific renal care management program significantly reduces hospital admissions within 1 year after the program implementation among patients with ESRD. Impacts of renal care management in a longer period need to be further studied.