Assessing the Impact of a Renal Care Management Program on Disease Progression Prior to and During the COVID-19 Pandemic

Résumé fourni par la source

Background: The transition to dialysis among chronic kidney disease (CKD) patients marks a significant change in health accompanied by increases in morbidity and health care costs. Delaying this transition means extending the patient's quality of life and cost savings. The effects of renal care management on the transition to dialysis and whether having access to the program impacts the risk of transitioning to dialysis as well as the timeline of transitioning to dialysis is necessary to study given the increased role of case management programs with the advent of the COVID-19 pandemic. Understanding the role of disease management programs provide direction for management programs across the globe Methods: The design is a retrospective, cohort study of patients in the US drawn from a national claims database who were identified as having CKD 4 or 5 on July 1, 2018. The data was analyzed to determine whether program access affected the rate of transition to dialysis and the likelihood of transitioning to dialysis from 2018 to 2020. Results: We followed the cohort of 7,992 participants (3,561 with access to Kidney Resource Services and 4,431 without access to Kidney Resource Services) during a two year period from 2018 to 2020. Those with access to Kidney Resource Services transitioned to dialysis later than those without access to the program. Further, after controlling for patient risk and characteristics, patients with access to the program had a 22 percent reduced risk of initiating dialysis compared to those without access. Conclusions: Patients with stage 4 or 5 CKD who have access to renal care management have a reduced risk of transitioning to dialysis as well as a later transition to dialysis compared to CKD patients without access to renal care management. Further research is needed given the increased need for education during and post the COVID-19 pandemic to address social and clinical determinants of health.

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