Descriptions of hospitalizations during 2019 among patients on dialysis in France

Résumé 0

IntroductionThe ability to indirectly link data from the French REIN registry and data from the French National Health Data System makes it possible to enhance knowledge of the care pathway of patients with severe kidney disease. Focusing on hospitalizations provides insight into the burden of this disease for both patients—in terms of comorbidities, complications, and quality of life—and also society—in terms of care burden, the need to arrange care, and care costs.MethodsPatients on dialysis in 2019 were identified from REIN data. The information on hospital stays was extracted from the French National Health Data System matched to REIN. The hospitalization rate corresponds to the number of hospital stays over the period, relative to the number of at-risk people on dialysis over the period.ResultsAfter excluding dialysis sessions, 36,962 patients had a hospital stay in 2019: 36,738 in medicine, surgery, or obstetrics, 2863 in rehabilitation, 531 as day cases, and 201 in psychiatry. This represents a total of 146,743 hospital stays, of which 140,372 were in medicine, surgery, or obstetrics. The hospitalization rate in medicine, surgery, or obstetrics was 259 stays for 100 person-years. The reasons vary by age, type of hospitalization (with or without an overnight stay), and mode of discharge (home, death, or transfer). The median costs for a hospital stay ranged from €7,920 in rehabilitation to €719 in medicine, surgery, or obstetrics without an overnight stay. Due to the volumes, hospital stays for cardiovascular disease represented a high total amount over the year. Hospitalizations for infection have significant median costs.Discussion and conclusionThe results presented in this article confirm the significant role of hospitalization in the trajectory of patients on dialysis. Hospitalizations in medicine, surgery, or obstetrics represent 96% of hospitalizations. For the first time, this study shows the very low proportion of hospitalizations in psychiatry and rehabilitation facilities.