In 2016, total Medicare spending for end-stage renal disease (ESRD) amounted to $35 billion, and among patients on dialysis, hospitalization accounted for 40% of total Medicare payments. Analyne Babaylan, BSN, RN, VA-BC, and Phung Tran, MSN, RN conducted a retrospective and descriptive survey to identify the top three discharge diagnoses for 30-day readmission of patients with ESRD on hemodialysis in a hospital setting. The researchers sought to determine the appropriate intervention to reduce admissions in that patient population.
Results of the study were reported during the virtual 2020 ANNA National Symposium in a session titled Top Three Discharge Diagnoses of 30-Day Readmission for End-Stage Renal Disease (ESRD) Patients on Hemodialysis in a Hospital Setting.
The study was conducted at a 143-bed, not-for-profit, full-service acute care hospital. The in-hospital dialysis unit has two beds and the dialysis team includes five nurses and one technician. Data were gathered using a reporting function from an electronic medical record system from January 1, 2018, through September 30, 2019.
Forty patients met the 30-day readmission criteria for the 21-month study period. Of the 40 patients, 24 were male with a median age of 66 years and 16 were female with a median age of 67 years; the age of the total study cohort ranged from 31 to 90 years. The average length of stay was 3.9 days. The top three discharge diagnoses were: (1) diabetes mellitus (22.4%); (2) hypertension (10.3%); and (3) acute respiratory failure with hypoxia, pneumonia, and sepsis (6.5%).
The authors said, “With one in three ESRD patients being readmitted within 30 days, results will be used to develop an intervention to educate staff and patients on how to manage their diabetes and hypertension during their dialysis treatment. Reducing hospital readmission for ESRD patients decreases morbidity and mortality and improves their quality of life.”
Source: Babaylan A, Tran P. Top three discharge diagnoses of 30-day readmission for end-stage renal disease (ESRD) patients on hemodialysis in the hospital setting. Abstract of a session presented during the virtual American Nephrology Nurses Association 2020 National Symposium, August 29-30, 2020.