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One key area of our research is Hematocrit level and its effect on your health. We believe that your health is benefited when your hematocrit is raised to a level greater than 30% as soon as possible, and that the longer your hematocrit is kept above 33% the better chance you have of living a longer life. We have also found that when your hematocrit is kept above 33% the chance of you being hospitalized decreases, and the length of your stays in the hospital will most likely be shorter.
Hospitalization Rate Calculation: Introduction
All causes and cause-specific hospitalizations can be analyzed for incident or prevalent patient populations. The hospitalization rates are calculated as average number of hospitalizations and average length of stay, adjusting for the length of patient follow-up period. Patients with multiple hospitalizations in the follow-up period will contribute multiple entries to the numerator and only one entry to the denominator in the calculation. For example, the hospitalization rates in 1994 can be calculated as:
Average number of hospitalizations in 1995 = total number of hospitalizations in 1995 * 1000
total patient follow-up years in 1995
Average length of stay in 1995 = total length of stay in 1995 * 1000
total follow-up patient years in 1995
Such calculations can be applied to all-cause and cause-specific hospitalizations. Enclosed are results of all cause hospitalization rates and cause specific rates derived from 1995 institutional inpatient claims (Part A). The hemodialysis and peritoneal dialysis patient population in the report is defined as those who were either alive on Jan 1, 1994 or new in 1994, and who have survived at least 90 days. The 90-day rule for selecting patient populations is necessary to ensure homogeneous follow-up for ESRD patients under age 65 compared to those above age 65, since patients under age 65 are not Medicare eligible until after the first three month of ESRD treatment. Patients are followed from Jan 1, 1995 (existing patients) or the 91st day after the first ESRD service date (new patients), up to the earliest time of transplantation, modality switches, loss-to-follow-up, or Dec 31, 1995. All the hospitalizations in the analyses are restricted to those occurring during the follow-up interval. Further, patients who had transplants prior to Jan 1, 1994 are excluded to simplify the analyses.
The endpoint is all-cause and cause-specific hospitalization rates in 1995. The hospitalization rates per patient follow-up year are presented for all patients, as well as for each age group, diabetic category, and race.
The 28 cause specific hospitalization categories were determined by ICD9 principal diagnosis codes. These categories are as follows:
We have also provided thematic maps which depict the numbers of inpatient days per year, by state and by Health Service Area (HSA), for all ESRD, all dialysis, hemodialysis, peritoneal dialysis, and transplant patients. This information is also provided for diabetic and non-diabetic patients.
Our data show that inpatient days for all ESRD patients are highest in the central and eastern part of the nation, while there appears to be an association of shorter hospital stays with areas having high numbers of managed care providers, such as California and Minnesota. It also appears that hospital stays are longer for diabetic patients.
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