Abstract: SA-PO1083
Health Care Costs and Utilisation for CKD among Hospitalised Patients in the Republic of Ireland
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 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
- Browne, Leonard, University of Limerick, Limerick, Ireland
- Tandan, Meera, University of Limerick, Limerick, Ireland
- Saran, Rajiv, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Stack, Austin G., University of Limerick, Limerick, Ireland
Group or Team Name
- National Kidney Disease Surveillance System and Quality Assurance Programme.
Background
To facilitate effective healthcare planning and resource allocation, comprehensive knowledge of the frequency, length of stay and costs of inpatient hospitalisation for chronic kidney disease (CKD) is crucial. To fill this deficit, we assesed rates of hospitalisation, length of stay (LOS), and associated costs for all CKD-related hospitalisations in Ireland.
Methods
A retrospective study of the National Hospital In-Patient Enquiry (HIPE) database in 2022. Non-coded hospitalisations and patients aged <1 year were excluded. All ICD-10 coded hospital admissions with a principal or additional CKD diagnoses were included. Age-standardised rates of hospitalisation and inpatient mortality were computed. We assessed hospitalisation, inpatient mortality, length of stay and costs by demographic factors, Charlson comorbidity score and region.
Results
In 2022, 13.1% of all coded hospitalisations in Ireland (n=225,164/1,711,564) recorded CKD as a principal diagnosis and/or additional diagnoses, costing €427 million. CKD-related hospitalisations excluding dialysis and transplantation as principal diagnoses represented 2.1% of all hospitalisations nationally, with 35,409 admissions from 23,261 patients, culminating in a total stay of 422,738 days, costing €320.3 million. The average LOS was 11.9 days and increased from 4.5 to 16.1 days with rising Charlson Comorbidity score. Stratified by comorbidity score, admissions, LOS, and costs rose significantly with increasing comorbidity burden. The leading principal diagnoses in 2022, when CKD was listed as an additional diagnosis included acute kidney failure, sepsis, heart failure, diabetes and pneumonia. CKD hospitalisation rates and inpatient mortality were higher in men and increased with age. Age standardised hospitalisation rates varied significantly across health regions and were lowest in the West and highest in the Midland regions of Ireland , P<0.01).
Conclusion
CKD exerts a substantial impact on healthcare utilisation and cost to the Irish health system. Increasing length of stay, resource utilisation, and in-hospital mortality, are especially common in older patients with higher comorbidity burden. Demographic and regional disparities in CKD hospitalisation rates highlight the need for targeted interventions and healthcare planning to address this public health issue effectively.
Funding
- Government Support – Non-U.S.