ArticleJournal of the American College of Emergency Physicians open2022
Emergency department visits for hemodialysis by insurance status in the United States.
Article in Journal of the American College of Emergency Physicians open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 2 citations in OpenAlex.
- Impact of health insurance status on hospitalization and mortality from emergency department admission in patients with end-stage kidney disease: a Korean nationwide registry analysis.Kidney research and clinical practice · 2026Article
- Emergency department visits for hemodialysis by insurance status in the United States.Journal of the American College of Emergency Physicians open · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Many uninsured patients with end-stage kidney disease (ESKD) depend upon the emergency department (ED) for hemodialysis (HD). We sought to characterize ED visits for emergent HD by insurance status. Methods: We performed a cross-sectional analysis of the 2017 Nationwide Emergency Department Sample, including ED visits by patients ≥18 years old with a length of stay ≤1 day and performance of HD. Insurance status determined by "insured" as Medicare, Medicaid, or commercial and "uninsured" as self-pay or charity. Results: Of 118,034,396 adult ED visits, 235,988 were associated with HD: uninsured 62,503 (incidence 5.30 per 10,000, 95% confidence interval [CI]: 5.26-5.34) and insured 172,889 (incidence 14.65 per 10,000, 95% CI: 14.60-14.74). The south census region accounted for 89% of uninsured ED HD (odds ratio [OR] 31.55, 95% CI: 8.97-110.97). Compared to insured patients, uninsured ED HD patients were more likely to be younger (age 18-44, 37.6% vs 19.9%). The most common primary diagnosis for uninsured and insured ED HD patients was hypertensive chronic kidney disease (34.6% and 26.2%, respectively). Uninsured ED HD patients were less likely to be admitted (3.4% vs 36.0%, OR 0.06, 95% CI: 0.02-0.20). Most ED HD patients were discharged home (95.2% uninsured vs 57.6% insured). ED charges per visit were $5,992.32 for uninsured and $10,985.87 for insured ED HD patients. Conclusions: Our findings highlight the health care burden of ED HD. Novel system approaches are needed for the management of uninsured and insured patients with ESKD.
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