V DIWAN 1,2, J ZHANG 1,2, Z WANG 1,2, H HEALY H2,3, W HOY 1,2, AND ON BEHALF OF CKD.QLD COLLABORATIVE
1Faculty of Medicine, The University of Queensland, Herston, Brisbane, Australia, 2NHMRC CKD.CRE and CKD.QLD, Herston, Brisbane, Australia, 3Queensland Health, Brisbane, Australia
Aim: To profile hospital admissions in a cohort of patients with preterminal CKD.
Background: Preterminal chronic kidney disease (CKD) imposes a substantial financial burden on health systems, yet the compartments of those costs are not clear. We analysed costs of hospital admissions on patients recruited to the CKD.QLD registry from 10 sites across Queensland.
Methods: Preterminal CKD patients were recruited to the registry with informed consent between May 2011 and June 2018. They were followed until the start of kidney replacement therapy (KRT), death or June 2018, for a total of 25,391.3 person years. Queensland Health supplied data on admissions to all Queensland hospitals, with ICD-10-AM codes, and costs, as well as outcomes (death and KRT).
Results: Among 7,212 patients, 5,828 patients (80.8%) were admitted at least once to hospital, with a total of 40,574 admissions, occasioning 155,899 hospital days and costing $226 million, or $8,901 per person year. Patients aged ≥75 yr, those with diabetic nephropathy and those with CKD stage 5 had the highest annualised costs. Of total costs, 82% ($185.3 million) was generated by conditions in 9 chapters (ICD-10-AM; First to Tenth Edition; 2017): circulatory system disease (19.3% of all costs), external causes, including femoral fracture, drug toxicities etc (10.5%), rehabilitation/consultation/discharge planning etc (9.2%), respiratory (8.2% ), CKD and genitourinary-related (8.1%), neoplasms (6.9%), musculoskeletal (6.9%), digestive system (6.2%), and endocrine/metabolic, including diabetes (5.9%).
Conclusions: CKD and kidney-related problems were the primary diagnosis in <10% of hospital costs in this CKD cohort. Other common conditions, many associated with ageing, predominated. We continue to analyse their interactions with CKD. High costs associated with rehabilitation, consultation, discharge planning etc are notable.
I work at CKD.QLD as research coordinator/manager, under the leadership of Prof Wendy Hoy, AO. My research focuses on CKD, related CVD complications, hospital admissions, cost and length of stay by various reasons of hospitalizations. My qualifications include a PhD (Pharmacology), Master and Bachelor in Pharmacy, and Certificate in Project management. After completing my PhD under the mentorship of A/Prof Glenda Gobe and Prof Lindsay Brown in 2013, I did my post-doc with A/Prof Ivan Sammut in Otago, NZ and returned to Brisbane in 2016 to work with QLD Health and then started with CKD.QLD in 2018.