Socioeconomic Factors Associated with Readmission after Deceased Donor Renal Transplantation

Abstract

Early hospital readmissions after kidney transplantation pose a significant financial burden and hardship for patients and health-care institutions alike. We sought to identify the risk factors associated with increased likelihood of readmission after transplantation, and examined to determine whether patient socioeconomic demographics impacted the likelihood of perioperative readmissions. We evaluated all deceased donor renal transplants performed at our institution between August 2011 and December 2015. In a cohort of 325 transplant operations that met our inclusion criteria, 117 (36%) were readmitted to the hospital within 90 days of discharge. In univariable analyses, length of stay and pretransplant disabled status were associated with increased likelihood of readmission within 90 days of transplant. When placed into multivariable models, there was a suggestion association with length of stay and disability status. Kidney donor profile index, estimated posttransplant survival, employment, race, age, and payor status were not associated with readmission. In conclusion, the factors associated with posttransplant readmission are not necessarily influenced by socioeconomic factors in our study population. The data collected in this single center study indicate that the factors associated with increased rates of readmission are likely clinical in nature.

Get full access to this article

View all access options for this article.

References

McAdams-Demarco

M.A.

, Gram

M.E.

, Hall

E.C.

Early hospital readmission after kidney transplantation: Patient and center-level associations.

Am J Transplant 2016; 12: 3283–8.

Gawlas

, Sethi

, Winner

Readmission after pancreatic resection is not an appropriate measure of quality.

Ann Surg Oncol 2013; 20: 1781–7.

United States Renal Data System. 2016 USRDS annual data report: Epidemiology of kidney disease in the United States. Bethesda: MD, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2016.

Center for Medicare & Medicaid Services.

Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals’ resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

Fed Regist 2012; 77: 53257–750.

Center for Medicare & Medicaid Services.

Medicaid program; payment adjustment for provider-preventable conditions including health care-acquired conditions. Final rule.

Fed Regist 2011; 76: 32816–38.

Center for Medicare & Medicaid Services. Readmissions Reduction Program. Available at: https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html. Accessed December 5, 2016.

Covert

K.L.

, Fleming

J.N.

, Staino

Predicting and preventing readmissions in kidney transplant recipients.

Clin Transplant 2016; 30: 779–86.

King

E.A.

, Kucirka

L.M.

McAdams-DeMarco, et al. Early hospital readmission after simultaneous pancreas-kidney transplantation: Patient and center-level factors.

Am J Transplant 2016; 16: 541–9.

A.H.

, Lam

N.N.

, Naylor

K.L.

Early hospital read-missions after transplantation: Burden, causes, and consequences.

Transplantation 2016; 100: 713–8.