(HealthDay News) — More than 10,000 uninsured patients in Texas sought hemodialysis in emergency departments in 2017, according to a research letter published online in JAMA Network Open.

Julianna West, from The University of Texas Health Science Center at Houston, and colleagues used the 2017 Texas Emergency Department Data Set to characterize emergency department visits for hemodialysis among insured and uninsured adult patients. The analysis was limited to patients with a stay of 1 day or less.

The researchers identified 33,829 emergency department visits associated with hemodialysis, including 10,390 uninsured patients (incidence, 1.24 cases per 1,000 adult emergency department visits) and 23,439 insured patients. Compared with insured patients, uninsured patients requiring hemodialysis were more likely to be younger (aged 18 to 44 years: 40.0 vs 24.0%), be of white race (66.1 vs 44.9%), and have Hispanic ethnicity (85.6 vs 54.0%). There were no significant sex differences noted, but there were regional variations. Most patients requiring hemodialysis in the emergency department were discharged to home or home health care. Total hospital costs were $21,837,047.40 for uninsured hemodialysis visits.

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“Strategies such as providing scheduled outpatient hemodialysis for uninsured patients with end-stage renal disease and treating insured patients in after-hours outpatient settings could be a cost-effective alternative to emergency department visits for hemodialysis, potentially alleviating system burdens, saving health care resources, and achieving improved patient outcomes,” the authors write.

One author disclosed receiving personal fees from a pharmaceutical company.


West J, Chan HK, Molony DA, et al. Insurance Status and Emergency Department Visits Associated With Hemodialysis in Texas. JAMA Netw Open. 2020;3(2):e1921447. doi: 10.1001/jamanetworkopen.2019.21447

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