Hospitalization among United States dialysis patients

Abstract

Measurements of hospitalization in the dialysis population are important because they provide insight into the morbidity and the cost of treatment among dialysis patients. Prior comparisons of hospitalization for different dialysis modalities have had conflicting results. This study was designed to compare hospitalization for patients treated with peritoneal dialysis (PD) versus hemodialysis (HD) using the data from the U.S. Renal Data System 1993 Annual Data Report. The study population included all Medicare dialysis patients prevalent on January 1, 1988 through 1990. Patients were monitored to transplantation, death, or end of the calendar year for a total of 189,654 patient years. Hospital admission rates were computed from the total number of hospital admissions during the year divided by the total number of patient years at risk. Patients were classified by treatment modality (PD, HD), cause of ESRD (diabetes as a cause of ESRD versus all other causes), age (0 to 19, 20 to 44, 45 to 65, +65), and race (black, white). Rate ratios (RR:PD/HD) for hospital admissions per year at risk were estimated, while adjusting for the other factors with Poison regression. On average, hospital admission rates per patient year at risk for dialysis patients treated with PD were 14% higher than for those treated with HD (RR = 1.14; 95% confidence interval (Cl), 1.13 to 1.15) when adjusting for race, age, gender, and cause of ESRD. The excess in the overall adjusted admission rates in PD patients compared with HD patients was higher for black than for white patients (RR:PD/HD = 1.22 versus RR = 1.11; 95% Cl, 1.10 to 1.13).(ABSTRACT TRUNCATED AT 250 WORDS)

The case for increased peritoneal dialysis utilization in low‐ and lower‐middle‐income countries

“…Hospitalization has economic implications as well as association with negative effects on QoL 73 . As with most comparisons between HD and PD, some studies have shown comparable hospitalization rates, 74 some have reported higher hospitalization rates in PD, 73,75 while others have found hospitalization rates to be lower in PD 76,77 . A Canadian study of 822 consecutive dialysis patients found that comparative hospitalization rates are heavily dependent on the analytic starting point and on whether intention‐to‐treat (ITT) or treatment‐received analyses are used 78 .…”

Do remote dialysis services really cost more? An economic analysis of hospital and dialysis modality costs associated with dialysis services in urban, rural and remote settings

“…Studies have suggested a relationship between the frequency and cost of hospitalisations and specific treatment modalities [ 13 – 16 ]. A few cost studies have also compared the delivery of dialysis treatments across different locations, noting the increased infrastructure and recurrent costs per patient per year associated with remote based services [ 17 – 19 ].…”

Effect of Combining Conventional and Telehealth Methods on Managing Peritoneal Dialysis Patients: A Retrospective Single-Center Study

“…The hospitalization rate was calculated as the annual number of residents in a defined area hospitalized with a positive SARS-CoV-2 laboratory test divided by the number of patients classified as critical within that defined area [ 8 ], expressed as n (%) hospitalizations per 100 patient-years [ 9 ].…”

“…e hospitalization rate was calculated as the annual number of residents in a defined area hospitalized with a positive SARS-CoV-2 laboratory test divided by the number of patients classified as critical within that defined area [8], expressed as n (%) hospitalizations per 100 patient-years [9]. e drop-out rate was calculated as the annual number of people who discontinued peritoneal dialysis divided by the total number of peritoneal dialysis patients for the same year and is expressed as n (%), representing the number of drop-outs per 100 patient-years.…”