Emergency department use among kidney transplant recipients in the United States

Brendan P. Lovasik, Rebecca Zhang, Jason M. Hockenberry, Justin D. Schrager, Stephen O. Pastan, Andrew B. Adams, Sumit Mohan, Christian P. Larsen, Rachel E. Patzer

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Patients with end-stage renal disease use the emergency department (ED) at a 6-fold higher rate than do other US adults. No national studies have described ED use rates among kidney transplant (KTx) recipients, and the factors associated with higher ED use. We examined a cohort of 132 725 adult KTx recipients in the United States Renal Data System (2005-2013). Data on ED visits, hospitalization, and outpatient nephrology visits were obtained from Medicare claims databases. Nearly half (46.1%) of KTx recipients had at least one ED visit (1.61 ED visits/patient-year [PY]), and 39.7% of ED visits resulted in hospitalization in the first year posttransplantation. ED visit rate was high in the first 30 days (5.26 visits/PY) but declined substantially thereafter (1.81 visits/PY in months 1-3; 1.13 visits/PY in months 3-12 posttransplantation). ED visit rates were higher in the first 30 days versus rates for dialysis patients but less than half the rate thereafter. Female sex, public insurance, medical comorbidities, longer pretransplantation dialysis vintage, and delayed graft function were associated with higher ED use in the first year post-KTx. Policies and strategies addressing potentially preventable ED visits should be promoted to help improve patient care and increase efficient use of ED resources.

Original languageEnglish (US)
Pages (from-to)868-880
Number of pages13
JournalAmerican Journal of Transplantation
Volume18
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

Bibliographical note

Funding Information:
The data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as official policy or interpretation of the US government. The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.To complete the MOC activity associated with this article and earn credit, please go to https://ASTS.org/MOC To complete the MOC activity associated with this article and earn credit, please go to https://ASTS.org/MOC

Publisher Copyright:
© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons

Keywords

  • clinical research/practice
  • health services and outcomes research
  • hospital readmission
  • kidney disease
  • kidney transplantation/nephrology
  • quality of care/care delivery

Fingerprint

Dive into the research topics of 'Emergency department use among kidney transplant recipients in the United States'. Together they form a unique fingerprint.

Cite this