Keywords: Uninsured, Acute Kidney Failure, Chronic Kidney Disease
Research Objective: To investigate the effect of insurance on Acute Kidney Failure (AKF), length of hospital stay and charges. Methods: Cross-sectional analyses was conducted for hospitalized patients ages 18-64 in South Carolina 2012 – 2013. Outcomes: diagnosed with AKF at hospital admission, charges, and length of stay. Key explanatory variable: Patient’s insurance status: self-pay vs. Medicaid vs. private insurance. Other covariates included patient’s age, gender, and race as well as risk factors for AKF including Type 2 Diabetic Mellitus (T2DM), Chronic Kidney Disease (CKD), Hypertension and Proteinuria. Multivariate logistic and linear regression models were used. Results: Having no insurance was found to be significantly associated with an increased risk of AKF. Uninsured patients incurred lower charges and were discharged earlier than those with Medicaid or private insurance. However, the presence of T2DM reversed this trend. Self-pay AKF patients with T2DM were charged 6% more and stayed in hospital 25% longer than similar patients with Medicaid. Conclusions: Insurance reduces the risk of hospitalized AKF and improves consequential hospital outcomes.