Back to Journals » ClinicoEconomics and Outcomes Research » Volume 9

In-center hemodialysis absenteeism: prevalence and association with outcomes

Authors Gray KS, Cohen DE, Brunelli SM

Received 9 March 2017

Accepted for publication 20 April 2017

Published 24 May 2017 Volume 2017:9 Pages 307—315


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Kathryn S Gray, Dena E Cohen, Steven M Brunelli

DaVita Clinical Research, Minneapolis, MN, USA

Objective: The aim of this study was to determine the rate of missed treatments among hemodialysis (HD) patients, and the association between treatment nonadherence and clinical outcomes.
Data source: The data used in this study were based on electronic medical records and Medicare claims.
Study design: This is a retrospective, observational study.
Principal findings: HD patients miss 9.9% of all treatments. Approximately half of the missed treatments are due to observable medical events, predominantly hospitalizations, while half result from nonadherence (“absence”). A single absence is associated with a 1.4-fold greater risk of hospitalization, and a 2.2-fold greater risk of death in the subsequent 30 days.
Conclusion: Treatment nonadherence is common among HD patients and is associated with adverse outcomes. Interventions that improve adherence may improve patient health and reduce costs.

Keywords: Medicare, ambulatory/outpatient care, epidemiology, chronic disease

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]