Systems and methods for determining patient hospitalization risk and treating patients

A method comprising:

• extracting patient data from one or databases corresponding to a pool of patients having end stage renal disease (ESRD);
• using a predictive model with the extracted patient data to generate, for each of the patients in the pool of patients, a respective expected probability for hospitalization within a predetermined time period;
• identifying a subset of the pool of patients having respective expected probabilities that are higher than other patients in the pool of patients;
• identifying, for each patient of the subset of the pool of patients, at least one factor from the patient data that increased the expected probability of hospitalization;
• and
• based on the identified factors, determining and executing clinical interventions to lower the probability of hospitalization within the subset of the pool of patients, wherein the clinical interventions include at least one of (a) administering one or more dialysis treatments in addition to a patient's existing dialysis schedule, (b) extending a patient's dialysis treatment time, (c) adjusting a patient's target weight for a dialysis treatment, (d) adjusting a dialysate sodium concentration for a patient's dialysis treatment, and (e) adjusting a patient's blood pressure medication.