30-Day All-Cause Readmission Outcomes Among Kidney Transplant 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 the end stage renal disease (ESRD) population. Kidney transplant (KTP) recipients with ADPKD have a higher rate of post-transplant complications, but evidence of their readmission outcomes is limited.
METHODS: A case-cohort analysis of patients ≥18 years old with an index hospitalization for KTP surgery between 01Jan2018-31Dec2018 and at least one 30-day all-cause readmission between 01Jan2018-31Jan2019 in the Premier Healthcare Database (PHD). The 30-day all-cause readmission rate, length of stay (LOS), and total cost at readmissions were compared for those with vs. without ADPKD using descriptive statistics. Logistic, negative binomial and quantile regressions were used to assess the association between ADPKD diagnosis and the 30-day all-cause readmission outcomes. Alpha level was set at ≤ 0.05.
RESULTS: Among 3,512 KTP recipients, 45% (n=1,582) had at least one 30-day all-cause readmission, which was lower for those with ADPKD (39.3%, n=112) compared to those without ADPKD (45.6%, n=1,470; p = 0.0419). A 0.01% lower odds of at least one 30-day all-cause readmission (OR: 0.99, 95% CI: 0.76-1.28, p = 0.9272), 15% lower odds of a longer mean LOS (IRR: 0.85, 95% CI: 0.72-1.01, p = 0.0687), and a higher incremental median total patient cost ($1,252; 95% CI: -$1,057-$3,088; p ≥ 0.05) was observed for KTP recipients with ADPKD.
CONCLUSIONS: Nearly half of KTP recipients experienced at least one 30-day all-cause readmission, highlighting the complexity in post-KTP care needs and the opportunity for improvement in the quality of KTP care in the US. The inpatient resource use and cost burden to hospitals financially responsible for 30-day all-cause readmissions was found to be similar for KTP recipients with and without ADPKD.
METHODS: A case-cohort analysis of patients ≥18 years old with an index hospitalization for KTP surgery between 01Jan2018-31Dec2018 and at least one 30-day all-cause readmission between 01Jan2018-31Jan2019 in the Premier Healthcare Database (PHD). The 30-day all-cause readmission rate, length of stay (LOS), and total cost at readmissions were compared for those with vs. without ADPKD using descriptive statistics. Logistic, negative binomial and quantile regressions were used to assess the association between ADPKD diagnosis and the 30-day all-cause readmission outcomes. Alpha level was set at ≤ 0.05.
RESULTS: Among 3,512 KTP recipients, 45% (n=1,582) had at least one 30-day all-cause readmission, which was lower for those with ADPKD (39.3%, n=112) compared to those without ADPKD (45.6%, n=1,470; p = 0.0419). A 0.01% lower odds of at least one 30-day all-cause readmission (OR: 0.99, 95% CI: 0.76-1.28, p = 0.9272), 15% lower odds of a longer mean LOS (IRR: 0.85, 95% CI: 0.72-1.01, p = 0.0687), and a higher incremental median total patient cost ($1,252; 95% CI: -$1,057-$3,088; p ≥ 0.05) was observed for KTP recipients with ADPKD.
CONCLUSIONS: Nearly half of KTP recipients experienced at least one 30-day all-cause readmission, highlighting the complexity in post-KTP care needs and the opportunity for improvement in the quality of KTP care in the US. The inpatient resource use and cost burden to hospitals financially responsible for 30-day all-cause readmissions was found to be similar for KTP recipients with and without ADPKD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE271
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Urinary/Kidney Disorders, STA: Surgery