Current trends in hospice care usage for dialysis patients in the USA.

Autor: Soipe AI; Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA. soipea@upstate.edu.; Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA. soipea@upstate.edu., Leggat JE; Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA., Abioye AI; Department of Global Health and Population, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA., Devkota K; Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA., Oke F; Hospice and Palliative Care Buffalo, 225 Como Park Blvd, Buffalo, NY, 14227, USA., Bhuta K; Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA.; Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA., Omotayo MO; Hospice and Palliative Care Buffalo, 225 Como Park Blvd, Buffalo, NY, 14227, USA.
Jazyk: angličtina
Zdroj: Journal of nephrology [J Nephrol] 2023 Sep; Vol. 36 (7), pp. 2081-2090. Date of Electronic Publication: 2023 Aug 09.
DOI: 10.1007/s40620-023-01721-w
Abstrakt: Background: The predictors and latest trends in hospice utilization, adequate duration of hospice care, and dialysis discontinuation without hospice enrollment among patients with end stage kidney disease are not fully known; the aim of this study was to assess them, analysing data from the United States Renal Data System.
Methods: Data from the United States Renal Data System for patients with kidney failure who died between January 1, 2012, and December 31, 2019, were analyzed. Chi-square and logistic regression were used to evaluate associations between outcomes of interest and predictors, while Joinpoint regression was used to examine trends.
Results: Among 803,049 patients, the median (IQR) age was 71 (17) years, 57% were male, 27% enrolled in hospice, 8% discontinued dialysis before death without hospice enrollment, and 7% remained in hospice for ≥ 15 days. Patients 65 years and older (adjusted odds ratio [aOR]: 2.75, 95% CI 2.71-2.79) and White race (aOR: 1.79, 95% CI 1.77-1.81) were more likely to enroll in hospice. White patients (aOR: 0.75, 95% CI 0.73-0.76) and those who never received a kidney transplant (aOR: 0.75, 95% CI 0.73-0.78) were less likely to have adequate duration of hospice care. Hospice enrollment and standardized duration of hospice care increased over time, with an average annual percentage change of 1.1% (95% CI 0.6-1.6) and 5% (95% CI 2.6-7.4), respectively.
Conclusions: Approximately one in every four patients with kidney failure who died between 2012 and 2019 had a history of hospice enrollment, while one in every 12 discontinued dialysis before death without hospice enrollment. There was an upward trend in the duration of hospice care.
(© 2023. The Author(s) under exclusive licence to Italian Society of Nephrology.)
Databáze: MEDLINE
Externí odkaz: