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

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

研究成果: 雜誌貢獻文章

5 引文 (Scopus)

摘要

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).

原文英語
頁(從 - 到)144-154
頁數11
期刊Taiwan Journal of Public Health
28
發行號2
出版狀態已發佈 - 四月 2009
對外發佈Yes

指紋

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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

引用此文

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

於: Taiwan Journal of Public Health, 卷 28, 編號 2, 04.2009, p. 144-154.

研究成果: 雜誌貢獻文章

Hung, Yen N. ; Wu, Shiao C. ; No, Yee Yung ; Ko, Po L. / Analysis on hospital utilization in hemodialysis patients with different types of access. 於: Taiwan Journal of Public Health. 2009 ; 卷 28, 編號 2. 頁 144-154.
@article{e524690733a2441dae5615f1c3f57863,
title = "Analysis on hospital utilization in hemodialysis patients with different types of access",
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).",
keywords = "Expenditure, Hemodialysis, Hospital utilization, Length of stay, Vascular access",
author = "Hung, {Yen N.} and Wu, {Shiao C.} and No, {Yee Yung} and Ko, {Po L.}",
year = "2009",
month = "4",
language = "English",
volume = "28",
pages = "144--154",
journal = "台灣公共衛生雜誌",
issn = "1023-2141",
publisher = "臺灣公共衛生學會",
number = "2",

}

TY - JOUR

T1 - Analysis on hospital utilization in hemodialysis patients with different types of access

AU - Hung, Yen N.

AU - Wu, Shiao C.

AU - No, Yee Yung

AU - Ko, Po L.

PY - 2009/4

Y1 - 2009/4

N2 - 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).

AB - 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).

KW - Expenditure

KW - Hemodialysis

KW - Hospital utilization

KW - Length of stay

KW - Vascular access

UR - http://www.scopus.com/inward/record.url?scp=67651085466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67651085466&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:67651085466

VL - 28

SP - 144

EP - 154

JO - 台灣公共衛生雜誌

JF - 台灣公共衛生雜誌

SN - 1023-2141

IS - 2

ER -