Determinants of hemodialysis access-related health care utilization in incarcerated and non-incarcerated populations

Little is known about the patterns of health care utilization in the U.S. prison population. Hemodialysis access-related health care utilization has been well investigated in non-incarcerated samples and therefore, maximizes opportunity for comparison with the incarcerated and non-incarcerated subgroups of our study cohort. To examine the independent and interaction effects of incarceration status and hemodialysis access-related risk factors on health care utilization outcomes, 149 males with end stage renal disease (ESRD) who received treatment at the University of Texas Medical Branch were examined in a retrospective cohort study. In multivariate analyses controlling for age, race, comorbid conditions, disease stage, hygiene, and incarceration status, only having diabetes proved predictive of hemodialysis access-related hospitalization and emergency department (ER) visits. Evaluation of interaction terms indicated that the effects of the covariates did not differ significantly according to incarceration status. The study showed that being incarcerated does not place one at increased risk for hemodialysis access-related health care utilization. Moreover, previously examined risk factors proved comparable in incarcerated and non-incarcerated samples.