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• W4224299292 abstract "Many uninsured patients with end-stage kidney disease (ESKD) depend upon the emergency department (ED) for hemodialysis (HD). We sought to characterize ED visits for emergent HD by insurance status.We performed a cross-sectional analysis of the 2017 Nationwide Emergency Department Sample, including ED visits by patients ≥18 years old with a length of stay ≤1 day and performance of HD. Insurance status determined by insured as Medicare, Medicaid, or commercial and uninsured as self-pay or charity.Of 118,034,396 adult ED visits, 235,988 were associated with HD: uninsured 62,503 (incidence 5.30 per 10,000, 95% confidence interval [CI]: 5.26-5.34) and insured 172,889 (incidence 14.65 per 10,000, 95% CI: 14.60-14.74). The south census region accounted for 89% of uninsured ED HD (odds ratio [OR] 31.55, 95% CI: 8.97-110.97). Compared to insured patients, uninsured ED HD patients were more likely to be younger (age 18-44, 37.6% vs 19.9%). The most common primary diagnosis for uninsured and insured ED HD patients was hypertensive chronic kidney disease (34.6% and 26.2%, respectively). Uninsured ED HD patients were less likely to be admitted (3.4% vs 36.0%, OR 0.06, 95% CI: 0.02-0.20). Most ED HD patients were discharged home (95.2% uninsured vs 57.6% insured). ED charges per visit were $5,992.32 for uninsured and $10,985.87 for insured ED HD patients.Our findings highlight the health care burden of ED HD. Novel system approaches are needed for the management of uninsured and insured patients with ESKD." @default.
• W4224299292 created "2022-04-26" @default.
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• W4224299292 date "2022-04-01" @default.
• W4224299292 modified "2023-10-16" @default.
• W4224299292 title "Emergency department visits for hemodialysis by insurance status in the United States" @default.
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• W4224299292 doi "https://doi.org/10.1002/emp2.12698" @default.
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