Health care costs associated with unrecognized progression to late-stage kidney disease.
Am J Manag Care
; 29(2): e64-e68, 2023 02 01.
Article
em En
| MEDLINE
| ID: mdl-36811990
ABSTRACT
OBJECTIVES:
Many individuals with chronic kidney disease (CKD) are undiagnosed or unaware of the disease and at risk of not receiving services to manage their condition and of "crashing" into dialysis. Past studies report higher health care costs among patients with delayed nephrology care and suboptimal dialysis initiation, but they are limited because they focused on patients undergoing dialysis and did not evaluate costs associated with unrecognized disease for patients "upstream," or patients with late-stage CKD. We compared costs for patients with unrecognized progression to late-stage (stages G4 and G5) CKD and end-stage kidney disease (ESKD) with costs for individuals with prior CKD recognition. STUDYDESIGN:
Retrospective study of commercial, Medicare Advantage, and Medicare fee-for-service enrollees 40 years and older.METHODS:
Using deidentified claims data, we identified 2 groups of patients with late-stage CKD or ESKD, one group with prior evidence of CKD diagnosis and the other without, and compared total and CKD-related costs in the first year following late-stage diagnosis between the 2 groups. We used generalized linear models to determine the association between prior recognition and costs and used recycled predictions to calculate predicted costs.RESULTS:
Total and CKD-related costs were 26% and 19% higher, respectively, for patients without prior diagnosis compared with those with prior recognition. Total costs were higher both for unrecognized patients with ESKD and unrecognized patients with late-stage disease.CONCLUSIONS:
Our findings indicate that costs associated with undiagnosed CKD extend to patients not yet requiring dialysis and highlight potential savings from earlier disease detection and management.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Renal Crônica
/
Falência Renal Crônica
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article