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Healthcare resource utilisation and cost associated with elevated potassium levels: a Danish population-based cohort
Kun Kim1, Reimar Wernich Thomsen2, Sia Kromann Nicolaisen2
1Health Economics, AstraZeneca Nordic-Baltic, Södertälje, Sweden, Södertälje, Sweden.
Insights
Hyperkalaemia (HK) significantly increases healthcare costs for patients with chronic kidney disease (CKD), heart failure (HF), or diabetes. Managing recurrent HK events is crucial for reducing the economic burden on healthcare systems.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Hyperkalaemia (HK) is a common complication in patients with chronic kidney disease (CKD), heart failure (HF), and diabetes.
- Understanding the economic impact of HK is essential for resource allocation and patient management.
Purpose of the Study:
- To investigate the healthcare costs associated with hyperkalaemia (HK) in patients with CKD, HF, or diabetes.
- To compare healthcare expenditures before and after a first HK event in these patient populations.
Main Methods:
- A before-after cohort study design was employed using population-based databases in Northern Denmark.
- Patients with incident CKD, HF, or diabetes between 2005-2011 were identified, and healthcare costs were analyzed 6 months before and after a first HK event.
- A matched comparison cohort without HK was used to isolate HK-associated costs.
Main Results:
- A significant proportion of patients with CKD, HF, and diabetes experienced incident HK events, with over 40% having recurrent events.
- HK-associated healthcare costs were substantial: €5077 for CKD patients, €6018 for HF patients, and €4862 for diabetes patients.
- These costs represent the increase in healthcare utilization and spending directly attributable to HK events.
Conclusions:
- Incident hyperkalaemia is prevalent among patients with CKD, HF, and diabetes, often leading to recurrent events.
- A significant increase in healthcare costs is associated with HK events in these high-risk populations.
- The findings highlight the considerable economic impact of HK, informing clinical decision-making and healthcare policy.
Objectives:
To investigate healthcare costs associated with hyperkalaemia (HK) among patients with chronic kidney disease (CKD), heart failure (HF) or diabetes.
Design:
Before-after cohort study of patients with HK and matched patients without HK.
Setting:
Population-based databases covering primary and secondary care for the entire of Northern Denmark.
Participants:
Patients with a first incident record of CKD (n=78 372), HF (n=14 233) or diabetes (n=37 479) during 2005-2011. Among all patients experiencing a first HK event (potassium level >5.0 mmol/L), healthcare costs were compared during 6 months before and 6 months after the HK event. The same cost assessment was conducted 6 months before and after a matched index date in a comparison cohort of patients without HK.
Primary And Secondary Outcome Measures:
Mean costs of hospital care, general practice and dispensed drugs converted to 2018 Euros.
Results:
Overall, 17 747 (23%) CKD patients, 5141 (36%) HF patients and 4183 (11%) diabetes patients with a first HK event were identified. More than 40% of all HK patients across the patient groups had subsequent HK events with successively shorter times between the events. In CKD patients, overall mean costs were €5518 higher 6 months after versus before first HK, while €441 higher in matched CKD patients without HK, yielding HK-associated costs of €5077. Corresponding costs associated with a HK event were €6018 in HF patients, and €4862 in diabetes patients.
Conclusions:
Among CKD, HF and diabetes patients, an incident HK event was common, and a large proportion of the patients experienced recurrent HK events. Substantial increase in healthcare costs associated with a HK event was observed in the HK patients compared with non-HK patients. These results are important to better understand the potential economic impact of HK among high-risk comorbid patients in a real-wold setting and help inform decision-making for clinicians and healthcare providers.
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