Social determinants of health associated with hemodialysis non-adherence and emergency department utilization: A pilot observational study
BMC Nephrology Jan 13, 2020
Balhara KS, et al. - Researchers undertook this prospective interdisciplinary pilot study including cases and controls, to explore social determinants of health (SDOH) related to missing hemodialysis (HD) and presenting to the emergency department (ED). They also focused on resource utilization related to such visits. Cases included a convenience sample of patients presenting to the ED following missing HD. Matched controls were patients at local dialysis centers recognized as HD-compliant by their nephrologists. Findings revealed elevated length of stay and admission rates that were consequent to ED visits following missed HD. No significant risk for missing HD was conferred by often-cited SDOH such as health literacy. However, cases exhibited higher pain, physical limitations, and depression. In recognizing risk factors particular to missed HD and ED use, forming strategies to enhance treatment adherence and decreasing unnecessary ED utilization, community-specific collaborations between EDs and dialysis centers would be helpful.
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