Analysis on hospital utilization in hemodialysis patients with different types of access

Yen N. Hung, Shiao C. Wu, Yee Yung No, Po L. Ko

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

To analyze the hospital utilization of end stage renal failure (ESRD) patients with different types of dialysis access in Taiwan. Methods: This analysis used claims data for all newly developed ESRD patients in 2002 from the Taiwan National Health Insurance (NHI) database provided by the Department of Health (DOH). Patients who died in the first year were excluded. We tracked all subjects for 12 months from the start of their dialysis access and reviewed data regarding the number of hospital admissions, length of stay, and expenditure. We grouped causes of admission according to the United States Renal Data System (USRDS) and used multiple regression to analyze the correlation between hospital utilization and type of vascular access by controlling other variables such as gender, age, co-morbidities, and time of access creation. Results: The leading causes of admission for 6,228 newly developed ESRD patients in 2002 were dialysis access related problems (23.92%-25.32%) and urology system related problems (22.03%-26.29%). The number of admissions, length of stay, and inpatient expenditure of ateriovenous graft (AVG) patients were significantly greater than those of arteriovenous fistula (AVF) patients during the first year post access creation. Conclusions: ESRD patients in Taiwan who accessed dialysis through AVG utilized more hospital resources than those with AVF. We encourage increasing the percentage of AVF creation rate for access. Lowering the incidence of access infection and thrombosis may also reduce medical expenditure on ESRD patients since access related problems were the leading cause of hospitalization of those patients. (Taiwan J Public Health. 2009;28(2):144-154).

Original languageEnglish
Pages (from-to)144-154
Number of pages11
JournalTaiwan Journal of Public Health
Volume28
Issue number2
Publication statusPublished - Apr 2009
Externally publishedYes

Fingerprint

Renal Dialysis
Chronic Kidney Failure
Taiwan
Dialysis
Arteriovenous Fistula
Health Expenditures
Length of Stay
Insurance Claim Review
Transplants
National Health Programs
Urology
Information Systems
Blood Vessels
Inpatients
Hospitalization
Thrombosis
Public Health
Regression Analysis
Databases
Morbidity

Keywords

  • Expenditure
  • Hemodialysis
  • Hospital utilization
  • Length of stay
  • Vascular access

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Analysis on hospital utilization in hemodialysis patients with different types of access. / Hung, Yen N.; Wu, Shiao C.; No, Yee Yung; Ko, Po L.

In: Taiwan Journal of Public Health, Vol. 28, No. 2, 04.2009, p. 144-154.

Research output: Contribution to journalArticle

Hung, Yen N. ; Wu, Shiao C. ; No, Yee Yung ; Ko, Po L. / Analysis on hospital utilization in hemodialysis patients with different types of access. In: Taiwan Journal of Public Health. 2009 ; Vol. 28, No. 2. pp. 144-154.
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abstract = "To analyze the hospital utilization of end stage renal failure (ESRD) patients with different types of dialysis access in Taiwan. Methods: This analysis used claims data for all newly developed ESRD patients in 2002 from the Taiwan National Health Insurance (NHI) database provided by the Department of Health (DOH). Patients who died in the first year were excluded. We tracked all subjects for 12 months from the start of their dialysis access and reviewed data regarding the number of hospital admissions, length of stay, and expenditure. We grouped causes of admission according to the United States Renal Data System (USRDS) and used multiple regression to analyze the correlation between hospital utilization and type of vascular access by controlling other variables such as gender, age, co-morbidities, and time of access creation. Results: The leading causes of admission for 6,228 newly developed ESRD patients in 2002 were dialysis access related problems (23.92{\%}-25.32{\%}) and urology system related problems (22.03{\%}-26.29{\%}). The number of admissions, length of stay, and inpatient expenditure of ateriovenous graft (AVG) patients were significantly greater than those of arteriovenous fistula (AVF) patients during the first year post access creation. Conclusions: ESRD patients in Taiwan who accessed dialysis through AVG utilized more hospital resources than those with AVF. We encourage increasing the percentage of AVF creation rate for access. Lowering the incidence of access infection and thrombosis may also reduce medical expenditure on ESRD patients since access related problems were the leading cause of hospitalization of those patients. (Taiwan J Public Health. 2009;28(2):144-154).",
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