| Impact of late-stage CKD and aging on medical utilization in the elderly population: a closed-cohort study in Taiwan. | |
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MedLine Citation:
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PMID: 20335272 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Taiwan has the highest incidence and prevalence of end-stage renal disease globally, especially in the elderly population. The elderly with chronic kidney disease (CKD) also had high mortality. However, population-based research on how the elderly with CKD utilize medical services is still unexplored. We aimed to examine the effects of CKD severity and aging on medical utilizations in the elderly population. METHODS: This retrospective closed cohort study analysed 7868 elderly residents of Kaohsiung City, who participated in the government-sponsored annual physical examination in 1997. The information of medical services and expenses were obtained from the claimed data of the National Health Insurance from 1996 to 1999. CKD was grouped into five stages according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF K-DOQI) criteria with modifications. Late-stage CKD was defined as CKD Stages 3 to 5 [estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m(2)]. Those subjects with eGFR above 60 ml/min/1.73 m(2) were treated as the reference group. RESULTS: After adjusting all covariates, the odds ratios of hospitalization for elderly subjects with CKD stages 3a, 3b and 4/5 were 1.19 (95% CI = 1.08-1.32), 1.48 (95% CI = 1.26-1.73) and 1.68 (95% CI = 1.21-2.33) compared with the reference group, respectively (P < 0.001). The autoregressive generalized estimating equation analysis revealed that CKD stage had linear associations with medical expenditures during the study period, especially for those elderly subjects with later stage CKD. CONCLUSION: Increases in medical utilizations and expenses were demonstrated in elderly CKD subjects, especially those with late stage CKD. Early prevention of CKD is necessary to lessen the financial impact on medical health care. |
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Authors:
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Ming-Yen Lin; Shang-Jyh Hwang; Lih-Wen Mau; Hung-Chun Chen; Su-Chen Hwang; Ling-Chu Wu; Herng-Chia Chiu |
Publication Detail:
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Type: Journal Article Date: 2010-03-24 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 25 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-23 Completed Date: 2011-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 3230-5 Citation Subset: IM |
Affiliation:
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Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aging* Chronic Disease Cohort Studies Cost of Illness Female Glomerular Filtration Rate Health Expenditures* Hospitalization Humans Kidney Diseases / economics*, epidemiology, prevention & control Kidney Failure, Chronic / economics Male Taiwan / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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