In-center hemodialysis absenteeism: prevalence and association with outcomes

OBJECTIVE: The aim of this study was to determine the rate of missed treatments among hemodialysis (HD) patients, and the association between treatment nonadherence and clinical outcomes. DATA SOURCE: The data used in this study were based on electronic medical records and Medicare claims. STUDY DESIGN: This is a retrospective, observational study. PRINCIPAL FINDINGS: HD patients miss 9.9% of all treatments. Approximately half of the missed treatments are due to observable medical events, predominantly hospitalizations, while half result from nonadherence (“absence”). A single absence is associated with a 1.4-fold greater risk of hospitalization, and a 2.2-fold greater risk of death in the subsequent 30 days. CONCLUSION: Treatment nonadherence is common among HD patients and is associated with adverse outcomes. Interventions that improve adherence may improve patient health and reduce costs.