IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i16p8359-d610074.html
   My bibliography  Save this article

Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data

Author

Listed:
  • Isabell Schellartz

    (Institute of Health Care Research, Rhineland State Council, LVR-IVF, 51109 Cologne, Germany
    Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology Health Services Research and Rehabilitation Science (IMVR), University of Cologne, 50933 Cologne, Germany)

  • Sunita Mettang

    (Betriebskrankenkasse (BKK) Linde, 65187 Wiesbaden, Germany)

  • Arim Shukri

    (Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, 50935 Cologne, Germany)

  • Nadine Scholten

    (Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology Health Services Research and Rehabilitation Science (IMVR), University of Cologne, 50933 Cologne, Germany)

  • Holger Pfaff

    (Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology Health Services Research and Rehabilitation Science (IMVR), University of Cologne, 50933 Cologne, Germany)

  • Thomas Mettang

    (Kidney Center Wiesbaden, 65191 Wiesbaden, Germany)

Abstract

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are medically equivalent alternatives for symptomatic therapy of end-stage renal disease (ESRD). An early referral (ER) of patients with chronic kidney disease (CKD) to a nephrological specialist is associated with a higher proportion of patients choosing PD. Germany historically shows a low PD uptake. This article is the first investigation into the impact of ER on the uptake of PD, using a large German claims database. Methods: Claims data of 4727 incident dialysis patients in 2015 and 2016 were analyzed. Accounting codes for nephrological care and dialysis modalities were identified. Their first documentation was defined as their first encounter with a nephrologist and their first dialysis treatment (HD or PD). ER was determined as receiving nephrological care at least six months before the first dialysis. A multivariate logistic regression model with adjusted odds ratios (AOR) investigates the impact of ER, outpatient dialysis start, age, comorbidities, and sex on the chance for PD. Results: Forty-three percent were referred to the nephrologist six months before their first dialysis (ER). Single tests, as well as the adjusted multivariate logistic regression, highlighted that ER significantly increases the chance for PD. In the multivariate model, the uptake of PD was associated with ER (AOR = 3.05; p < 0.001; 95% CI = 2.16–4.32), outpatient dialysis start (AOR = 0.71; p = 0.044; 95% CI = 0.51–0.99), younger age (AOR = 0.96; p < 0.001; 95% CI = 0.95–0.97), and fewer comorbidities (AOR = 0.85; p < 0.001; 95% CI = 0.44–1.58). Conclusions: ER of patients with CKD to a nephrologist increases PD uptake. It gives both nephrologists and patients enough time for patient education about different treatment options and can contribute to informed decisions about the dialysis treatment.

Suggested Citation

  • Isabell Schellartz & Sunita Mettang & Arim Shukri & Nadine Scholten & Holger Pfaff & Thomas Mettang, 2021. "Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data," IJERPH, MDPI, vol. 18(16), pages 1-10, August.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8359-:d:610074
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/16/8359/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/18/16/8359/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Johanna Callhoff & Hannes Jacobs & Katinka Albrecht & Joachim Saam & Angela Zink & Falk Hoffmann, 2020. "Factors Associated with Survey Non-Response in a Cross-Sectional Survey of Persons with an Axial Spondyloarthritis or Osteoarthritis Claims Diagnosis," IJERPH, MDPI, vol. 17(24), pages 1-13, December.
    2. Miquel Sitjar-Suñer & Rosa Suñer-Soler & Afra Masià-Plana & Emilia Chirveches-Pérez & Carme Bertran-Noguer & Concepció Fuentes-Pumarola, 2020. "Quality of Life and Social Support of People on Peritoneal Dialysis: Mixed Methods Research," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Arim Shukri & Thomas Mettang & Benjamin Scheckel & Isabell Schellartz & Dusan Simic & Nadine Scholten & Martin Müller & Stephanie Stock, 2022. "Hemodialysis and Peritoneal Dialysis in Germany from a Health Economic View—A Propensity Score Matched Analysis," IJERPH, MDPI, vol. 19(21), pages 1-11, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8359-:d:610074. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.