HOSPITALIZATION PATTERNS OF PATIENTSON DIALYSIS : A DESCRIPTIVE STUDY AT THREE PUBLIC PRIVATE PARTNERSHIP CLINICS IN SOUTH INDIA

Introduction:

Hospitalization rates among dialysis patients serve as a critical indicator of overall patient health and the quality of care provided. Understanding the patterns and causes of these hospitalizations can provide valuable insights for improving patient outcomes and optimizing care. This study aims to analyze the hospitalization rates and related factors for dialysis patients during a selected period of 6 months in 3 dialysis centers operating on  public private partnership(PPP) model in Andhra Pradesh, India.

Methods:

This descriptive study was conducted over a 6-month period. The study population included all patients undergoing dialysis treatment at the selected clinics during this time. Data were collected from patient medical records & data captured in electronic medical records (EMR), focusing on key hospitalization variables such as patient age, frequency of hospital admissions, average length of hospital stay, primary reasons for admission, percentage of patients getting admitted per month, and the number of dialysis sessions missed due to hospitalization. Data was analyzed to identify trends and correlations, aiming to improve clinical care by identifying patterns and reducing missed dialysis sessions.

Results:

A total of 285 patients were followed up for 6 months. 73% of the patients were male and the combined mean age was 52.6±14.1 years.  66% were on thrice a week dialysis and the rest on twice a week sessions. A total of 136 hospital admissions were recorded - 69% of them among males. . The age group most frequently admitted was 50 years and older, contributing to 70% of hospitalizations with a mean age of 52.2 years(±18.4 SD).

The average length of hospital stay was 9.5±7.8 days per admission of which 29% were for  less than 24 hours, 38% were up to 3 days & 18% were for more than a week. Reasons for admission included issues related to arteriovenous  access(27%), dyspnea (22%) and due to catheters (16%).  Monthly hospitalization rates remained relatively stable, averaging 10% of the total patient population per month .

Additionally, an average of 5.3±3.8  dialysis sessions at the PPP centers were missed per hospitalization, leading to 245 missed dialysis sessions over the study period.  The patients generally continued to be dialyzed at the hospitals they were admitted in. Most of the patients returned for regular dialysis after discharge and only four patients died during the period of hospitalization. 

Conclusions:

The study reveals that dialysis patients over 50 are at a higher risk of hospitalization due to respiratory issues and vascular access complications, with an average stay of 9.5 days and 5.3 missed sessions. These findings emphasize the need for targeted interventions to reduce respiratory complications and improve vascular access management in older patients on dialysis, ultimately aiming to minimize hospitalizations and maintain consistent dialysis care. 

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.