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Uninsured Kidney Patients Often End Up in ERs

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THURSDAY, March 5, 2020 (HealthDay News) — In a finding that likely applies to emergency rooms across the United States, researchers report that over 10,000 uninsured patients needed lifesaving kidney dialysis at Texas emergency departments in 2017.

Those patients incurred almost $22 million in hospital costs, the University of Texas Health Science Center scientists said.

The kidneys remove waste and fluid from the blood. With non-functional kidneys, dialysis, a treatment involving a blood-purifying machine, is needed. Dialysis treatments are about four hours in duration and occur three times every week. As regular treatment isn’t feasible for many uninsured patients, they often have to wait until the need for dialysis is life-threatening.

“This is a real problem facing these patients,” said study author Julianna West, a medical student at the university. “They have gone weeks without dialysis, and then they present in life-threatening crisis to the emergency department. This requires many hospital personnel and resources to treat their dire condition, and takes time and resources away from other patients that also need emergent treatment.”

Study co-author Dr. John Foringer explained that “this is a very sick population — the population with the highest morbidity rate in any emergency department.” Foringer is chief of medicine at Harris Health Lyndon B. Johnson Hospital, in Houston.

“This study is important because there is little data available that really captures the magnitude of the issue. Without data, it is difficult to improve resource utilization to manage these patients,” Foringer added in a university news release.

Emergency dialysis is also a big expense, carrying a price tag eight times higher than scheduled dialysis, the researchers said.

Another study co-author, Dr. David Robinson, former chief of emergency medicine of Harris Health, said, “The emergency department, which often serves as the safety net for the indigent, was being used as an acute safety net for a serious chronic disease.”

Robinson added that “a system that treats the patient only when gravely ill provides less quality of care and is less cost-effective than investing in a program that schedules the unfunded kidney disease patients with a dialysis slot.”

The findings were published online recently in JAMA Network Open.

— Kayla McKiski

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SOURCE: University of Texas Health Science Center, news release, Feb. 19, 2020