Inpatient Resource Use and Cost of Hospitalization for Kidney Transplant Surgery Among Recipients with vs. without Autosomal Dominant Polycystic Kidney Disease
Author(s)
Laura A. Clark, BS, MS, PhD1, Christopher M. Blanchette, MA, MBA, MSc, PhD2, Rosa C. Banuelos, PhD3, Jeanette M. Bennett, PhD4, Reuben Howden, PhD4;
1UNC Charlotte, Public Health, Charlotte, NC, USA, 2Novo Nordisk, Plainsboro, NJ, USA, 3Ontada, Woodlands, TX, USA, 4UNC Charlotte, Charlotte, NC, USA
1UNC Charlotte, Public Health, Charlotte, NC, USA, 2Novo Nordisk, Plainsboro, NJ, USA, 3Ontada, Woodlands, TX, USA, 4UNC Charlotte, Charlotte, NC, USA
Presentation Documents
OBJECTIVES: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic condition accounting for 5-10% of patients diagnosed with end-stage renal disease (ESRD) in the US and Europe. ADPKD patients have a higher rate of kidney transplantation (KTP) within the first year of initiating dialysis compared to the total ESRD population in the US. However, inpatient resource use and cost outcomes of patients with ADPKD and receiving KTP are limited.
METHODS: A case-cohort analysis of patients ≥18 years old with hospitalization for KTP surgery between 01Jan2018-31Dec2018 in the Premier Healthcare Database (PHD). Demographics, comorbidities, length of stay [LOS], and total patient cost at hospitalization for KTP surgery were compared for those with vs. without ADPKD using chi-square and Wilcoxon Signed-Rank Sum tests with alpha level set at ≤ 0.05.
RESULTS: Among 3,512 KTP recipients (ADPKD=285 vs. non-ADPKD=3,227), there was no difference in median (IQR) age (56 [47-62] vs. 55 [43-63] years old; p = 0.1658), but a higher proportion of recipients with ADPKD were aged 55-64 (35% vs. 29%) and 45-54 (28% vs. 21%) years old (p < 0.0001). A higher proportion of recipients with ADPKD were female (46% vs. 38%; p = 0.0050). Recipients with ADPKD had a lower comorbidity burden and better health status even though a higher proportion had uncomplicated hypertension (17% vs. 7%; p < 0.0001). The median (IQR) LOS (4 [4-6] vs. 5 [4-7] days; p = 0.0006) and total patient cost ($103,000 [$72,000-$128,000] vs. $113,000 [$75,000-$139,000]; p = 0.0010) were significantly lower among recipients with ADPKD.
CONCLUSIONS: KTP recipients with ADPKD impose less inpatient resource use and cost burden on hospitals compared to those without ADPKD. This is likely due to a lower comorbidity burden among recipients with ADPKD, resulting in a shorter post-surgical observation time and utilization of inpatient resources.
METHODS: A case-cohort analysis of patients ≥18 years old with hospitalization for KTP surgery between 01Jan2018-31Dec2018 in the Premier Healthcare Database (PHD). Demographics, comorbidities, length of stay [LOS], and total patient cost at hospitalization for KTP surgery were compared for those with vs. without ADPKD using chi-square and Wilcoxon Signed-Rank Sum tests with alpha level set at ≤ 0.05.
RESULTS: Among 3,512 KTP recipients (ADPKD=285 vs. non-ADPKD=3,227), there was no difference in median (IQR) age (56 [47-62] vs. 55 [43-63] years old; p = 0.1658), but a higher proportion of recipients with ADPKD were aged 55-64 (35% vs. 29%) and 45-54 (28% vs. 21%) years old (p < 0.0001). A higher proportion of recipients with ADPKD were female (46% vs. 38%; p = 0.0050). Recipients with ADPKD had a lower comorbidity burden and better health status even though a higher proportion had uncomplicated hypertension (17% vs. 7%; p < 0.0001). The median (IQR) LOS (4 [4-6] vs. 5 [4-7] days; p = 0.0006) and total patient cost ($103,000 [$72,000-$128,000] vs. $113,000 [$75,000-$139,000]; p = 0.0010) were significantly lower among recipients with ADPKD.
CONCLUSIONS: KTP recipients with ADPKD impose less inpatient resource use and cost burden on hospitals compared to those without ADPKD. This is likely due to a lower comorbidity burden among recipients with ADPKD, resulting in a shorter post-surgical observation time and utilization of inpatient resources.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE163
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Urinary/Kidney Disorders, STA: Surgery