In this cohort study, compared with non-dialysis care, patients who received maintenance dialysis spent more time in the hospital and were more likely to be admitted to intensive care units.

This finding suggests trade-offs between longer survival and higher intensity of use of health care services as a function of dialysis initiation.

Maintenance dialysis may be a proxy for the type of philosophy of care driving increased in-hospital time and intensive care and less use of palliative care.

A total of 968 patients were included in the analysis.

Patients who underwent dialysis spent more adjusted in-hospital days per person-year. However, the dialysis group did not have a higher rate of hospital admissions.

Patients in the dialysis group had a higher rate of intensive care unit admissions per 1000 hospitalizations and lower rates of inpatient palliative care per 1000 in-hospital days.

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