SHM Converge Scientific Abstract ePoster Gallery-Hospitalization Characteristics Among Patients With End-Stage Kidney Disease Experiencing Homelessness

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This retrospective cohort study used the National Inpatient Sample (2016–2020) to examine hospitalization characteristics among U.S. adults with end-stage kidney disease (ESKD) by homeless status, identified using ICD-10 code Z59.0. Among 881,681 unweighted hospitalizations for ESKD, 4,923 were associated with homelessness (0.56% weighted).<br /><br />Compared with non-homeless patients with ESKD, hospitalized patients experiencing homelessness were younger (median age 52 vs. 63 years), more often male (75% vs. 54%), and more likely to be non-Hispanic Black (50% vs. 35%). They were also more likely to have Medicaid as their primary payer (44% vs. 12%) and to live in large central metropolitan areas (52% vs. 37%).<br /><br />Hospitalization patterns differed as well. Patients experiencing homelessness had a lower rate of elective admission (3% vs. 9%) and slightly lower total charges (median $40,473 vs. $45,218), while length of stay was similar (median 4 days in both groups). Discharge outcomes showed important differences: 64% of homeless patients were discharged routinely to self-care, 14% left against medical advice, and only 15% were discharged to a skilled nursing facility or other facility, compared with 51%, 3%, and 22%, respectively, among non-homeless patients. In-hospital mortality was lower among patients experiencing homelessness (1.2% vs. 5%).<br /><br />The authors conclude that homelessness among hospitalized ESKD patients is associated with younger age, Black race, Medicaid coverage, and less stable discharge disposition, suggesting that homelessness may contribute to kidney disease disparities. They call for further research on the downstream effects of these discharge patterns and for patient-centered interventions to improve care and outcomes for people with ESKD experiencing homelessness.

Asset Subtitle

Jana Kholy

Meta Tag

Author List Delphine Tuot, Jana Kholy, Pranav Garimella, Sri Lekha Tummalapalli, Tala Al-Rousan, Tessa Novick

Category Research

Concept End-stage Kidney Disease

Concept Homelessness

Concept Hospitalization

Concept Inpatient Mortality

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization University of Texas Southwestern Medical Center

Presenting Author Jana Kholy

Track Outcomes Research

Keywords

end-stage kidney disease

homelessness

hospitalization

National Inpatient Sample

ICD-10 Z59.0

discharge disposition

Medicaid

non-Hispanic Black

length of stay

in-hospital mortality

End-stage Kidney Disease

Homelessness

Hospitalization

Inpatient Mortality

Retrospective Cohort Study