Comparative Analysis of Preventive Health Care Service Use in Patients with CKD and the General Population Using the Behavioral Risk Factor Surveillance System Dataset

Background: Chronic kidney disease (CKD) patients make up 13.5% of Medicare beneficiaries, but accounts for almost a quarter of its spending. Preventive health care has been widely regarded as the most cost effective intervention. The utilization rate has remained low in CKD population. Limited data is available comparing the utilization rate in CKD and non-CKD population. Methods: We did a secondary analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) dataset, which is the largest continuously conducted health survey system in the world. Preventive health care services were categorized into vaccination and cancer screening. A descriptive analysis was performed using SAS Studio. Preventive service utilization was compared using chi-squared test and multivariate logistic regression models. Results: The sample size was 433,323. 37.4% were of age 65 and higher, 61.8% were female, 31.6% had Medicare, 4.7% reported to have kidney disease, which has been assumed to be self-reported CKD for the purposes of this analysis. Multivariate logistic regression models were created to compare the vaccination rates in CKD and non-CKD patients while adjusting for age, sex, diabetes, insurance and employment status. Table shows that patients with CKD have higher odds for getting vaccines (p<0.0001) and that there is no difference in cancer screening among CKD and non CKD patients. Conclusion: Vaccination is encouraged and may be responsible for our higher rates. Although cancer incidence is higher in CKD patients, historically screening has not been considered cost-effective and has often been discouraged. This may have been reflected in our study. Multivariate logistic regression model comparing vaccination and cancer screening rate in CKD and general population - Service OR CI p-value Influenzaee 1.8 1.7-2 <0.0001 Pneumococcus 1.3 1.2-1.4 <0.0001 Shingles 2.1 2-2.3 <0.0001 Covid 1.5 1.2-1.8 <0.0001 Lung cancer 1.1 .8-1.5 .6 Colon cancer 0.6 .3-1.1 .1 Ca prostate 1.2 .1-1.5 .2 Ca breast 0.9 .1-19.2 .9 Ca cervix 1.2 .1-13 .9