Abstract: TH-PO308
Association of Heavy Precipitation with In-Center Dialysis Treatment Absenteeism
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Walker, Adam G., Davita Clinical Research, Minneapolis, Minnesota, United States
- Colson, Carey, Davita Clinical Research, Minneapolis, Minnesota, United States
- Sibbel, Scott, Davita Clinical Research, Minneapolis, Minnesota, United States
- Ahmad, Mesbah, DaVita Inc, Denver, Colorado, United States
- Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
- Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
Background
Dialysis treatment absenteeism (i.e., skipping a treatment for reasons other than hospitalization) is associated with greater risk for poor clinical outcomes. Adverse weather (e.g., excessive rainfall or snow accumulation) may pose additional challenges to treatment attendance for dialysis patients dependent upon public transportation or ride assistance. We sought to examine the impact of heavy precipitation on absentee rates.
Methods
This study retrospectively compared absentee patterns at 2,780 dialysis clinics at a kidney care organization in the United States on days with and without precipitation during the first half of 2022 (rain or snow, considered separately). Precipitation data was gathered from the Global Historical Climatology Network (GHCN) for weather stations near all clinics included in the analysis. Weather patterns and absences were considered daily for each clinic during the study periods (excluding Sundays). Associations were estimated using a linear mixed model with a random intercept for clinic using a zero-inflated Poisson distribution adjusted for day of the week, calendar month, and United States census region. The number of absences attributed to precipitation during the study period were estimated using a recycled predictions method based on observed proportion of days above the thresholds for rain or snow.
Results
Average absences were 4.0% relatively greater on days with ≥ 0.5 inches of rain than on days with <0.5 inch of rain (4.2% vs. 3.8%). Absences were 52% relatively greater on days with snow vs. days without snow (6.5% vs. 3.8%). Snow related absentee rates are higher for the Southern region (12.5%) than the Midwestern, Northeastern, or Western regions of the US (6.2%, 4.8%, and 5.4% respectively).
Conclusion
These results suggest that weather patterns are associated with dialysis absences; snow had a greater impact compared to rain. Proactive rescheduling during periods of inclement weather may represent an opportunity to improve clinical outcomes and treatment adherence. Transit authorities that facilitate nonemergent medical transportation should ensure outreach to dialysis patients before arrival of inclement weather.