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Abstract: TH-PO217

Health Care Resource Use and Costs in the Year Following a Major Bleeding Event in Patients with and Without ESKD

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Victores, Alejandro, Merck & Co Inc, Rahway, New Jersey, United States
  • Bash, Lori D., Merck & Co Inc, Rahway, New Jersey, United States
  • Roetker, Nicholas S., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Ramey, Dena Rosen Rosen, Merck & Co Inc, Rahway, New Jersey, United States
  • Wetmore, James B., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Bonaca, Marc P., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Patients with end-stage kidney disease (ESKD) are at an elevated risk of major bleeding events which may result in substantial healthcare resource use(HCRU). There is limited information on HCRU following a major bleeding event in those with ESKD.


Retrospective cohorts of patients ≥66 years were created using the US Renal Data System (USRDS) for ESKD patients receiving in-center hemodialysis (HD) and 20% sample general Medicare database for non-ESKD patients. The index date was the date of hospital admission for an incident major bleeding event between 2015 and 2019. Only those enrolled in Medicare Part D were included in follow-up analysis. All-cause HCRU and costs were calculated (including the index event) for up to 1 year. HCRU is expressed as a percent or rate per 100 person-years. Per person per year adjusted costs are expressed in 2019 dollars.


A total of 68,608 non-ESKD patients and 11,881 ESKD patients with incident major bleeding were included in the follow-up analysis. Patients with ESKD had significantly more admissions, inpatient days, and emergency visits than those without. Use of outpatient (OP) cardiac rehabilitation was significantly lower among ESKD patients. Post-index OP encounters had the largest magnitude difference, with 460.8 more OP encounters per 100 person-years among those with ESKD. Total costs for inpatient encounters, observation unit visits, ED visits, and OP encounters were statistically significantly higher for ESKD patients compared with non-ESKD patients.


In the year following an incident major bleed, Medicare beneficiaries with ESKD have significantly higher all-cause HCRU and total healthcare costs than patients without ESKD who experienced the same event; these differences persist after adjustment.


  • Commercial Support – Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA