Predicting hospital cost in CKD patients through blood chemistry values
نویسندگان
چکیده
BACKGROUND Controversy exists in predicting costly hospitalization in patients with chronic kidney disease and co-morbid conditions. We therefore tested associations between serum chemistry values and the occurrence of in-patient hospital costs over a thirteen month study period. Secondarily, we derived a linear combination of variables to estimate probability of such occurrences in any patient. METHOD We calculated parsimonious values for select variables associated with in-patient hospitalization and compared sensitivity and specificity of these models to ordinal staging of renal disease.Data from 1104 de-identified patients which included 18 blood chemistry observations along with complete claims data for all medical expenses.We employed multivariable logistic regression for serum chemistry values significantly associated with in-patient hospital costs exceeding $3,000 in any single month and contrasted those results to other models by ROC area curves. RESULTS The linear combination of weighted Z scores for parathyroid hormone, phosphorus, and albumin correlated with in-patient hospital care at p<0.005. ROC curves derived from weighted variables of age, eGFR, hemoglobin, albumin, creatinine, and alanine aminotransferase demonstrated significance over models based on non-weighted Z scores for those same variables or CKD stage alone. In contrast, the linear combination of weighted PTH, PO4 and albumin demonstrated better prediction, but not significance over non-weighted Z scores for PTH alone. CONCLUSION Further study is justified to explore indices that predict costly hospitalization. Such metrics could assist Accountable Care Organizations in evaluating risk adjusted compensation for providers.
منابع مشابه
Author's response to reviews Title: Predicting Hospital Cost in CKD Patients through Blood Chemistry Values Authors:
متن کامل
Relating illness complexity to reimbursement in CKD patients
BACKGROUND Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treat...
متن کاملLactulose efficacy in reduction of nitrogen products, blood potassium and fluid overload in patients with end-stage renal failure.
Abstract Introduction. Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stage disease. Patients with chronic kidney disease (CKD) face with uremic toxins and hyperkalemia. Also fluid overload in CKD patients is associated with rapid decline in kidney function. Lactulose is a hyper osmotic agent and as a prebiotic could reduce serum urea and p...
متن کاملProposed Method for Predicting COVID-19 Severity in Chronic Kidney Disease Patients Based on Ant Colony Algorithm and CHAID
Background and Objective: The COVID-19 pandemic is a phenomenon that has infected and killed many people worldwide. Underlying diseases such as diabetes mellitus, heart failure, and chronic kidney disease (CKD) can affect the severity of COVID-19 and aggravate patients' condition. This study aimed to predict the severity of the COVID-19 disease in CKD patients by combining feature selection and...
متن کاملEvaluation of chronic kidney disease and associated factors in psoriasis patients at Razi hospital, Tehran, Iran
Background: Psoriasis is a chronic and recurrent inflammatory disease that involves skin, joints and different organ systems. It is associated with Multiple morbidities such as cardiovascular disorders, diabetes, hypertension, hyperlipidemia and chronic kidney disease (CKD). Due to the high importance of the association between psoriasis and CKD which results in major side effects the aim of th...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 12 شماره
صفحات -
تاریخ انتشار 2011