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Multiple comorbid conditions and healthcare resource utilization among adult patients with hyperkalemia: A
Dingwei Dai1, Ajay Sharma1, Paula J Alvarez2
1CVS Health Clinical Trial Services LLC, Woonsocket, RI, USA.
Insights
Multiple comorbid conditions (MCCs) are highly prevalent in adult hyperkalemia patients, significantly increasing healthcare resource utilization and costs. Understanding these associations is crucial for managing hyperkalemia patients effectively.
Area of Science:
- Nephrology
- Internal Medicine
- Health Services Research
Background:
- Hyperkalemia is a serious electrolyte imbalance.
- Comorbid conditions (CCs) are common in hyperkalemia patients.
- The impact of multiple comorbid conditions (MCCs) on healthcare resource utilization (HRU) and costs in hyperkalemia is not fully understood.
Purpose of the Study:
- To estimate the prevalence of specific CCs and MCCs in adult patients with hyperkalemia.
- To examine the associations between MCCs and HRU and costs in this population.
Main Methods:
- Retrospective observational cohort study using administrative claims data.
- Identified patients with hyperkalemia (ICD-10-CM: E87.5, serum potassium >5.0 mEq/L, or specific medication use).
- Utilized association rule mining to identify MCCs and generalized linear models to assess associations with HRU and costs.
Main Results:
- 94% of 22,154 hyperkalemia patients had ≥3 CCs.
- Most common CCs included chronic kidney disease (CKD), hypertension (HTN), hyperlipidemia (HLD), and diabetes mellitus (DM).
- Increased CCs were significantly associated with higher ED visits, hospital stays, and total healthcare costs (p < 0.0001).
Conclusions:
- Multiple comorbid conditions (MCCs) are highly prevalent in adult patients with hyperkalemia.
- MCCs are strongly associated with increased healthcare resource utilization and costs.
- These findings highlight the importance of managing comorbidities in hyperkalemia care.
Objectives:
To estimate the prevalence of specific comorbid conditions (CCs) and multiple comorbid conditions (MCCs) among adult patients with hyperkalemia and examine the associations between MCCs and healthcare resource utilization (HRU) and costs.
Methods:
This retrospective observational cohort study was conducted using a large administrative claims database. We identified patients with hyperkalemia (ICD-10-CM: E87.5; or serum potassium >5.0 mEq/L; or NDC codes for either patiromer or sodium polystyrene sulfonate) during the study period (1/1/2016-6/30/2019). The earliest service/claim date with evidence of hyperkalemia was identified as index date. Qualified patients had ≥12 months of enrolment before and after index date, ≥18 years of age. Comorbid conditions were assessed using all data within 12 months prior to the index date. Healthcare resource utilization and costs were estimated using all data within 12 months after the index date. Association rule mining was applied to identify MCCs. Generalized linear models were used to examine the associations between MCCs and HRU and costs.
Results:
Of 22,154 patients with hyperkalemia, 94% had ≥3 CCs. The most common individual CCs were chronic kidney disease (CKD, 85%), hypertension (HTN, 83%), hyperlipidemia (HLD, 81%), and diabetes mellitus (DM, 47%). The most common dyad combination of CCs was CKD+HTN (71%). The most common triad combination was CKD+HTN+HLD (62%). The most common quartet combination was CKD+HTN+HLD+DM (36%). The increased number of CCs were significantly associated with increased ED visits, length of hospital stays, and total healthcare costs (all p-value < 0.0001).
Conclusions:
MCCs are very prevalent among patients with hyperkalemia and are strongly associated with HRU and costs.
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