Abstract: TH-PO1009
Health-Related Social Needs and CKD in Medicare Advantage Beneficiaries
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Bengtson, Lindsay, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
- Wong, Anny C., Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
- Rothenburger, Alexandra, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
- White, Zackery R., Unite Us, New York, New York, United States
- Terry, Amanda, Unite Us, New York, New York, United States
- Ahmadi-Montecalvo, Halima, Unite Us, New York, New York, United States
- Donato, Bonnie M.k., Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
Background
The impact of health-related social needs (HRSNs) on patient outcomes has been established; however, there is limited research regarding HRSNs and chronic kidney disease (CKD). This study addresses this gap by identifying HRSN predictors of CKD diagnosis at stage 3 vs. stages 1 or 2 and examining the association between HRSNs and concordance with guideline-recommended CKD management in the year following diagnosis.
Methods
A retrospective database analysis was conducted of Medicare Advantage beneficiaries newly diagnosed with CKD stages 1-3 from January 2020 to October 2022. Patients’ HRSNs were identified using Unite Us’ Social Needs System (SNS), a proprietary index leveraging public and consumer data to identify individual-level social risk. Logistic regression assessed the effect of HRSNs on the likelihood of diagnosis at stage 3 vs. stages 1 or 2. Logistic and linear regression examined the effect of HRSNs on healthcare utilization (HCU) and CKD management in the year following diagnosis, adjusted for CKD stage. Analyses were adjusted for age, sex, race/ethnicity, urbanity, comorbidities, and baseline HCU.
Results
A total of 6,053 individuals with CKD were included (median age 76 years; 97% English-speaking; 54% female; 84% White, non-Hispanic). CKD stage at diagnosis varied: stage 1 (2%), stage 2 (18%), and stage 3 (80%). Identified HRSNs included a lack of internet access (15%), food insecurity (10%), and financial insecurity (8%). While individuals with HRSNs tended to be diagnosed at stage 3 vs stage 1 or 2, differences were not statistically significant. Women (OR: 1.34; CI: 1.17-1.54, p<0.01) and older individuals (OR: 1.04; CI: 1.02-1.65, p<0.01) were more likely to be diagnosed at stage 3 than stages 1 or 2, while those with proteinuria (OR: 0.49; CI: 0.35-0.68, p<0.01) or living in rural counties (OR: 0.72; CI: 0.61-0.84, p<0.01) were less likely. In the year following diagnosis, patients with financial insecurity, versus those without, had an increased number of ER visits (β: 0.15; CI: 0.01-0.29, p=0.01) and were less likely to receive diabetes education (OR: 0.40; CI: 0.16-0.97, p=0.04).
Conclusion
These findings emphasize that specific HRSNs impact CKD management and present opportunities for targeted interventions to address HRSN barriers to care for individuals with CKD.
Funding
- Commercial Support – Boehringer Ingelheim