title: PATTERNS OF HEALTHCARE ENCOUNTERS EXPERIENCED BY PATIENTS WITH CHRONIC KIDNEY DISEASE.
abstract: BACKGROUND
  Patterns of healthcare encounters by patients in each stage of chronic kidney disease (CKD) have not been fully described.
  
  
  OBJECTIVE
  This study describes patterns of healthcare resource use by patients with CKD.
  
  
  METHODS
  A retrospective descriptive design was used.
  
  
  METHODS
  Patients with Stages 1-5 CKD were identified in five existing de-identified healthcare insurance claims databases in the United States using codes from the International Classification of Diseases (ICD-9-CM).
  
  
  METHODS
  The databases contained more than 23,660,000 claims records from over 11 million subscribers who were continuously enrolled in a single 2014 health plan. All CKD patients' 2014 claims were extracted, yielding 1,987 unique people with 110,594 healthcare encounters.
  
  
  RESULTS
  Healthcare resources are used to manage the causes of CKD and its multiple effects on health, and thus the number of healthcare encounters among people with more advanced disease was, as expected, relatively higher. There were more hospitalisations, emergency department visits and specialist encounters in this group. Surprisingly, however, even people in earlier stages of kidney disease experienced a median of 14-17 healthcare encounters during a single calendar year.
  
  
  CONCLUSIONS
  Understanding patterns of healthcare encounters provides important information about the transition experiences of patients with CKD. Exploring ways to reduce the risks associated with transitions in care may prevent problems with home medication management, frequent emergency department visits and potentially avoidable hospitalisations.
authors.affiliation: Indiana University School of Nursing, Indianapolis, Indiana, USA.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Welch
authors.affiliation: Indiana University School of Nursing, Hendersonville, North Carolina, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Meek
authors.affiliation: Indiana University School of Nursing, Indianapolis, Indiana, USA.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Bartlett Ellis
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, Indiana, USA.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ambuehl
authors.affiliation: Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Decker
mesh_terms: D001130:Arizona; D002140:California; D003695:Delivery of Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D009505:Nevada; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D012189:Retrospective Studies
keywords: Chronic kidney disease; Healthcare utilisation; Self-management/self-care