Hospitalization and Emergency Department Visit Rates in Medicare Hemodialysis Patients

Orlando—Prevalent hemodialysis patients covered by Medicare have declining rates of hospitalization; however, rates of emergency department encounters and admissions for observation have increased. Researchers, led by David Gilbertson, recently conducted an analysis of concurrent trends of those acute encounters with the healthcare system in that patient population.

Results of the analysis were reported during a poster session at the NKF 2017 Spring Clinical Meetings. The poster was titled Trends in Hospitalization, Emergency Department, and Observation Stays in Prevalent Hemodialysis Patients. The researchers were associated with Peer Kidney Care Investigators, Minneapolis, Minnesota.

The research team utilized data from the United States Renal Data System for 2004 to 2013 to compute unadjusted rates of hospitalization, emergency department encounters, and observation stays.

During the study period, rates of hospitalizations declined from 206 to 164 per 100 patient-years. Rates of emergency department encounters and observation stays increased from 166 per 100 patient-years in 2004 to 200 per 100 patient-years by the end of 2013. The combined burden of hospitalizations or emergency department encounters/observation stays remained relatively constant from 2004 until 2011; there was a slight decline thereafter, reaching 350 per 100 patient-years in 2013.

In summary, the researchers said, “Emergency department encounters/observation stays have now exceeded hospitalization rates, and decreases in hospitalizations have been mostly offset by increases in emergency department encounters/observation stays. The combined acute interactions with the healthcare system are almost four per patient per year.”

Source: CDRG and the chief medical officers of Peer Kidney Care Initiative. Trends in hospitalization, emergency department, and observation stays in prevalent hemodialysis patients. Abstract of a poster presented at the National Kidney Foundation 2017 Spring Clinical Meetings, April 19-22, 2017, Orlando, Florida.