Key result
Hyperkalemia hospitalizations linked to ~$30,000 higher 1-year costs and increased readmissions versus controls.
Why the study?
Limited evidence is available regarding the postdischarge economic and readmission burdens of hyperkalemia.
Are hyperkalemia-related hospitalizations associated with higher postdischarge health care costs and readmissions compared to hospitalizations without hyperkalemia?
Cohort (n=8,852)
Are hyperkalemia-related hospitalizations associated with higher postdischarge health care costs and readmissions compared to hospitalizations without hyperkalemia?
Hyperkalemia-related hospitalizations are associated with significantly higher postdischarge healthcare costs, resource utilization, and readmission rates compared to matched non-hyperkalemia hospitalizations.
Hyperkalemia hospitalizations link to excess costs and readmissions; leaves open whether prevention reduces utilization in cardiorenal patients.
Introduction Limited evidence is available regarding the postdischarge economic and readmission burdens of hyperkalemia. Methods Using the IBM MarketScan Commercial and Medicare-Supplemental Claims database (January 1, 2010–December 31, 2014), adult patients with a hospitalization with a hyperkalemia diagnosis (ICD-9-CM 276.7, hyperkalemia cohort) were 1:1 matched with patients with a hospitalization without evidence of hyperkalemia (nonhyperkalemia cohort) on age, chronic kidney disease stage, heart failure, dialysis, renin-angiotensin-aldosterone system inhibitor use, and major diagnostic categories of the hospitalization. All-cause health care costs and health care resource utilization measures were compared between cohorts during the 1-year postdischarge period. Postdischarge readmission and length of stay (LOS) were compared between hyperkalemia-related hospitalizations from the hyperkalemia cohort and matched hospitalizations unrelated to hyperkalemia from the nonhyperkalemia cohort. Results Patients with hyperkalemia-related hospitalizations ( n = 4426) incurred $30,379 (95% confidence interval, $25,423–$35,335) higher 1-year total all-cause costs ($68,861 vs. $38,482) and had higher rates of inpatient admissions (1.0 vs. 0.4), emergency department visits (2.0 vs. 1.2), and outpatient visits (49.6 vs. 39.1) than the nonhyperkalemia cohort during the 1-year postdischarge study period (all P < 0.001). Hyperkalemia-related hospitalizations ( n = 5377) were associated with significantly higher readmission rates (within 30 days: 0.15 vs. 0.09; 60 days: 0.25 vs. 0.16; 90 days: 0.36 vs. 0.23; all P < 0.001), longer LOS per readmission (8.1 vs. 7.1 days), and longer total inpatient days (10.5 vs. 5.8 days) compared with hospitalizations unrelated to hyperkalemia (all P < 0.001). Similar trends were observed across comorbidity subgroups. Conclusion Hyperkalemia-related hospitalizations were associated with significant economic and readmission burdens during the 1-year postdischarge period .
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Betts et al. (2020) conducted a cohort in Hyperkalemia (n=8,852). Hyperkalemia-related hospitalization vs. Hospitalization without evidence of hyperkalemia was evaluated on 1-year total all-cause costs (MD 30379, 95% CI 25423-35335, p=<0.001). Hyperkalemia-related hospitalizations were associated with $30,379 higher 1-year total all-cause costs ($68,861 vs. $38,482; P<0.001) and higher readmission rates compared to controls.
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