Provision of Temporary Access to Inpatient Hemodialysis to Uninsured Patients Initiating Hemodialysis

Can hospital length of stay (LOS) be shortened for uninsured inpatients initiating hemodialysis (HD) by allowing them temporary, postdischarge, outpatient access to a first-in-state, regulatorily approved transitional HD unit, until their insurance activates, enabling HD center placement?This quality improvement study with 951 participants found that offering postdischarge, transitional outpatient access to an inpatient HD unit shortened hospital LOS by a mean of 5 days for uninsured patients newly initiating HD.This study suggests that offering transitional HD services to uninsured inpatients newly initiating HD, who otherwise could not access outpatient HD until insurance became active, was associated with a significantly reduced hospital LOS.

Corresponding Author: Brad Spellberg, MD, Hospital Administration, Los Angeles General Medical Center, 2051 Marengo St, C2K122, Los Angeles, CA 90033 (bspellberg@dhs.lacounty.gov).

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