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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

DOI https://doi.org/10.2147/CEOR.S136577

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

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

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