Post-transplant Hospitalization Rates in a Safety Net Hospital

Background: USRDS reports hospitalization rates in ESRD patients in the Medicare population. Post transplantation, admission rates increase and then decrease to below pretransplant levels. It is not known if these trends are consistent in the Medicaid population. Less is known about hospitalization related to dialysis and renal disease. Methods: Analysis: We retrospectively reviewed the medical records of patients that received a kidney transplant during 2018 and 2019 . For 2018 transplants, data collected 3 yrs pre and 5 years post-transplant on 45 patients. For patients transplanted in 2019, data collected 3 yrs pre and 4 years post-transplant on 32 patients. Data was collected on ER visits and hospital admissions for related to their kidney disease only. Non-kidney related admissions were censored as this time overlapped with the COVID pandemic. Censoring COVID related admissions would make this data more comparable to historical data. Only admissions to the County of Los Angeles Hospitals were captured Results: Both Groups showed an increase in hospitalization rates post-transplant years 1 and 2. For patients transplanted in 2018, hospitalizations decreased by year 4 post-transplantation. For patients transplanted in 2019, hospitalizations decreased by year 3 post-transplant. Conclusion: Rates of hospitalization post-transplant in patients with lower socioeconomic status mirror hospitalization trends in the Medicare population. This cohort uniquely confirms the trend toward lower hospitalization after the initial years post-transplant in the same group of patients. Only hospitalizations at the safety-net system were captured; these patients were followed closely by the transplant center, and outside hospitalizations were not reported.