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In-center hemodialysis absenteeism: prevalence and association with outcomes
Kathryn S Gray1, Dena E Cohen1, Steven M Brunelli1
1DaVita 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.
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