HOSPITALISATION RATES IN PREVALENT PATIENTS ON COMMUNITY BASED HAEMODIALYSIS DIALYSIS (CHD) 

Aim:To describe the hospitalisation rate for prevalent patients on haemodialysis in National Kidney Foundation.

Background:One of the objective of community haemodialysis is to keep patients out of the hospital. However, many studies showed that admissions/readmissions are common in dialysis patients. Hospitalisations affect the quality of life in HD patients and have profound economic and financial consequences. We therefore set out to study the hospitalisation of prevalent HD patients, reasons for hospitalisation and length of stay.

Methods:All prevalent patients on NKF HD programmes as at July 2017 were included in the study. These patients were monitored for hospitalisation events for 1 year. Hospitalised patients, not discharge at the end of 1 year, were follow up till discharged. Every hospitalisation episode was captured and discharge diagnosis coded by staff in Clinical Affairs Department.

There were 3435 prevalent HD patients on the programme as at July 2017. 380(11%) exited, 9% due to death, transplanted(0.6%) and others(1.4%). Patient’s characteristics: mean age 62years ±11.3 with age <65years old(56.8%) and ≥65years old(43.2%) ; Ethnic distribution: Chinese(59.4%), Malay(30%), Indian(7.6%) and Others(3%); Male(56.4%), female(43.6%); 62.3% were diabetes, 92.3% hypertensive, 46% cardiovascular diseases,15.5% Peripheral Vascular Diseases(PVD) with 31% having more than ≥3 comorbidities. Among the prevalent patients, 53.5% were on the programme for 1-5 years, 5.1-10 years(25.3%) and ≥ 10.1 years(21.2%).

Results:There were 7744 hospitalisation episodes from 2439 patients during the study period. This is equivalent to 2.4 hospitalisation episodes per patient year(ppy). Among the 3435 prevalent patients, 71.3% were admitted at least once. Poisson Regression was used to evaluate the effects of age and medical comorbidities on hospitalisation burden. In both univariate and multivariate analysis, age, diabetes, cardiovascular and PVD are statistically significant (p value <0.05). 

Conclusions:Hospitalisation is common in haemodialysis patients. 71.3% of patients were admitted at least once per year and hospitalisation rate was 2.4 ppy.