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2018 ; 3
(2
): 343-355
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gab.com Text
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English Wikipedia
Potentially Avoidable Readmissions in United States Hemodialysis Patients
#MMPMID29725638
Mathew AT
; Rosen L
; Pekmezaris R
; Kozikowski A
; Ross DW
; McGinn T
; Kalantar-Zadeh K
; Fishbane S
Kidney Int Rep
2018[Mar]; 3
(2
): 343-355
PMID29725638
show ga
INTRODUCTION: Patients with end-stage kidney disease have a high risk of 30-day
readmission to hospital. These readmissions are financially costly to health care
systems and are associated with poor health-related quality of life. The
objective of this study was to describe and analyze the frequency, causes, and
predictors of 30-day potentially avoidable readmission to hospital in patients on
hemodialysis. METHODS: We conducted a retrospective cohort study using the US
Renal Data System data from January 1, 2008, to December 31, 2008. A total of
107,940 prevalent United States hemodialysis patients with 248,680 index hospital
discharges were assessed for the main outcome of 30-day potentially avoidable
readmission, as identified by a computerized algorithm. RESULTS: Of 83,209 30-day
readmissions, 59,045 (70.1%) resulted in a 30-day potentially avoidable
readmission. The geographic distribution of 30-day potentially avoidable
readmission in the United States varied by state. Characteristics associated with
30-day potentially avoidable readmission included the following: younger age,
shorter time on hemodialysis, at least 3 or more hospitalizations in preceding 12
months, black race, unemployed status, treatment at a for-profit facility, longer
length of index hospital stay, and index hospitalizations that involved a
surgical procedure. The 5-, 15-, and 30-day potentially avoidable readmission
cumulative incidences were 6.0%, 15.1%, and 25.8%, respectively. CONCLUSION:
Patients with end-stage kidney disease on maintenance hemodialysis are at high
risk for 30-day readmission to hospital, with nearly three-quarters (70.1%) of
all 30-day readmissions being potentially avoidable. Research is warranted to
develop cost-effective and transferrable interventions that improve care
transitions from hospital to outpatient hemodialysis facility and reduce
readmission risk for this vulnerable population.