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Dialysis
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Hospital Utilization among Chronic Dialysis Patients

PRADEEP ARORA, ANNAMARIA T. KAUSZ, GREGORIO T. OBRADOR, ROBIN RUTHAZER, SAMINA KHAN, CONSTANCE S. JENULESON, KLEMENS B. MEYER and BRIAN J. G. PEREIRA
JASN April 2000, 11 (4) 740-746;
PRADEEP ARORA
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ANNAMARIA T. KAUSZ
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GREGORIO T. OBRADOR
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ROBIN RUTHAZER
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SAMINA KHAN
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CONSTANCE S. JENULESON
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KLEMENS B. MEYER
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BRIAN J. G. PEREIRA
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    Figure 1.

    (A) Causes of inpatient utilization (hospitalizations). (B) Causes of inpatient utilization (hospital days).

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    Table 1.

    Univariate analyses: inpatient and outpatient utilization per patient-year at riska

    VariableFirst 3 MonthsAfter 3 MonthsOverall
    Hospital DaysHospitalizationsOutpatient VisitsHospital DaysHospitalizationsOutpatient VisitsHospital DaysHospitalizationsOutpatient Visits
    aResults are given as number of days in the hospital, number of hospitalizations, and number of outpatient visits per patient-year at risk. ESRD, end-stage renal disease; HMO, health maintenance organization; EPO, erythropoietin.
    bP <0.05.
    cP <0.01.
    dP <0.001.
    Overall28.34.320.512.91.916.114.92.216.6
    Age (yr)
    18 to 443.23.229.0b6.21.814.4c7.01.916.8
    45 to 6425.63.921.114.92.019.916.22.219.6
    65 to 7536.04.516.517.52.113.920.12.415.7
    >7539.06.115.99.61.69.814.12.311.0
    Gender
    female31.94.419.214.52.114.816.62.415.3
    male24.04.222.11.01.517.912.41.918.6
    Race
    Caucasian34.64.922.016.71.818.119.6b2.318.8
    non-Caucasian21.33.718.910.22.015.611.42.215.8
    Cause of ESRD
    diabetes mellitus38.95.323.718.8b2.6b21.4c21.8b3.0b21.7c
    non-diabetes mellitus22.73.818.910.51.613.912.01.914.5
    Insurance
    non-HMO33.8c4.9b21.414.02.015.616.52.416.3
    HMO6.72.117.47.31.218.17.31.418.0
    First vascular access
    permanent22.7b4.417.4b12.12.015.213.72.415.5
    temporary41.95.224.514.61.815.516.42.116.4
    Years of dialysis
    10/92 to 9/9437.45.120.226.0d2.316.529.2d3.117.5
    10/94 to 9/9620.13.222.89.31.616.410.41.817.0
    10/96 to 12/9725.04.517.611.62.015.512.82.215.7
    Modality of dialysis
    peritoneal dialysis15.52.522.614.22.518.312.32.516.0
    hemodialysis30.74.720.112.61.715.315.82.118.7
    Timing of referral
    early24.44.221.111.91.916.113.62.216.8
    late42.44.818.216.22.015.919.62.416.2
    Serum albumin (g/dl)
    <3.536.0b4.820.516.5b2.4b16.719.2b2.7b17.2
    3.5 and high17.63.920.78.71.314.99.81.615.6
    Hematocrit (%)
    >2828.74.919.513.72.017.015.72.417.3
    <2828.43.522.211.51.814.913.62.015.7
    GFR at initiation of dialysis
    >5 ml/min per 1.73 m231.44.821.614.02.016.116.42.316.9
    <5 ml/min per 1.73 m221.03.217.610.61.615.411.91.815.6
    EPO use
    yes22.63.616.2b14.51.815.415.72.015.5
    no31.74.722.912.32.016.414.72.317.2
    Ischemic heart disease
    no18.4d3.719.69.1d1.5d15.910.2d1.8d16.5
    yes46.85.521.323.22.916.827.13.317.3
    Congestive heart failure
    no23.14.321.19.61.615.111.3b1.915.8
    yes34.24.320.316.62.317.318.92.517.7
    Peripheral vascular disease
    no23.13.820.29.9c1.7b15.711.6d1.9b16.2
    yes43.25.722.322.92.117.625.93.118.3
    Hepatic disease
    no29.44.320.712.61.7b15.814.72.1b16.4
    yes22.04.720.815.63.118.516.73.418.8
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    Table 2.

    Factors associated with hospital utilization (hospital days per patient-year at risk)a

    First 3 MonthsAfter 3 Months
    VariableRelative Risk95% Confidence IntervalRelative Risk95% Confidence Interval
    aMultivariate model adjusted for the interaction between race and severe anemia.
    bDiabetes mellitus as a cause of ESRD.
    Age (yr)
    18 to 440.40.2 to 1.00.60.2 to 1.7
    45 to 640.50.3 to 1.01.00.5 to 2.1
    65 to 750.50.3 to 1.00.90.4 to 1.8
    >75 (ref)1.01.0
    Female gender (ref = male)0.90.6 to 1.51.50.8 to 2.7
    Diabetes mellitusb (ref = non-diabetes mellitus)1.61.0 to 2.71.50.9 to 2.7
    Insurance
    non-HMO (ref = HMO)9.92.3 to 42.11.30.5 to 3.3
    Ischemic heart disease present (ref = absent)1.71.0 to 2.81.81.0 to 3.3
    Year of dialysis
    10/92 to 9/941.60.9 to 2.82.41.3 to 4.4
    10/94 to 9/961.30.7 to 2.50.80.5 to 1.5
    10/96 to 9/98 (ref)1.0
    Late referral (ref = early)2.01.2 to 3.41.00.5 to 1.9
    Temporary access for first dialysis (ref = permanent)1.91.2 to 2.91.40.8 to 2.4
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Journal of the American Society of Nephrology: 11 (4)
Journal of the American Society of Nephrology
Vol. 11, Issue 4
1 Apr 2000
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Hospital Utilization among Chronic Dialysis Patients
PRADEEP ARORA, ANNAMARIA T. KAUSZ, GREGORIO T. OBRADOR, ROBIN RUTHAZER, SAMINA KHAN, CONSTANCE S. JENULESON, KLEMENS B. MEYER, BRIAN J. G. PEREIRA
JASN Apr 2000, 11 (4) 740-746;

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Hospital Utilization among Chronic Dialysis Patients
PRADEEP ARORA, ANNAMARIA T. KAUSZ, GREGORIO T. OBRADOR, ROBIN RUTHAZER, SAMINA KHAN, CONSTANCE S. JENULESON, KLEMENS B. MEYER, BRIAN J. G. PEREIRA
JASN Apr 2000, 11 (4) 740-746;
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More in this TOC Section

  • Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2
  • Features of Chronic Hemodialysis Practice after the Marmara Earthquake
  • The Relationship Between Systemic and Whole-Body Hematocrit Is Not Constant during Ultrafiltration on Hemodialysis
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