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Soipe AI, Leggat JE, Abioye AI, Devkota K, Oke F, Bhuta K, Omotayo MO. Current trends in hospice care usage for dialysis patients in the USA. J Nephrol 2023; 36:2081-2090. [PMID: 37556052 DOI: 10.1007/s40620-023-01721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/30/2023] [Indexed: 08/10/2023]
Abstract
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.
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Affiliation(s)
- Ayorinde I Soipe
- 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.
| | - John E Leggat
- Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA
| | - Ajibola I Abioye
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Kriti Devkota
- Division of Nephrology, Department of Medicine, Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA
| | - Fausat Oke
- Hospice and Palliative Care Buffalo, 225 Como Park Blvd, Buffalo, NY, 14227, USA
| | - Kunal Bhuta
- 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
| | - Moshood O Omotayo
- Hospice and Palliative Care Buffalo, 225 Como Park Blvd, Buffalo, NY, 14227, USA
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