Document Detail


Cost analysis of renal replacement therapies in Finland.
MedLine Citation:
PMID:  14655195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Costs for treating patients with end-stage renal disease (ESRD) have grown noticeably. However, most of the cost estimates to date have taken the perspective of the payers. Hence, direct costs of treating ESRD are not accurately known. METHODS: Files of all adult patients with ESRD who entered dialysis therapy between January 1, 1991, and December 31, 1996, were studied retrospectively, and all use of health care resources and services was recorded. Follow-up continued until December 31, 1996. RESULTS: Two hundred fourteen patients fulfilled the study criteria, 138 patients started with in-center hemodialysis (HD) therapy, and 76 patients started with continuous ambulatory peritoneal dialysis (CAPD) therapy. Patients were followed up until death (72 patients) or treatment modality changed for more than 1 month. Fifty-five patients received a cadaveric transplant, and after transplantation (TX), they were examined as a separate group of TX patients. Direct health care costs for the first 6 months in the HD, CAPD, and TX groups were 32,566 US dollars, 25,504 dollars, and 38,265 dollars, and for the next 6 months, 26,272 dollars, 24,218 dollars, and 7,420 dollars, respectively. During subsequent years, annual costs were 54,140 US dollars and 54,490 dollars in the HD group, 45,262 dollars and 49,299 dollars in the CAPD group, and 11,446 dollars and 9,989 dollars in the TX group. Regression analyses showed 4 variables significantly associated with greater daily costs in dialysis patients: age, ischemic heart disease, nonprimary renal disease, and HD treatment. CONCLUSION: Compared with HD, CAPD may be associated with lower costs, yet the absolute difference is not striking. After the TX procedure is performed once, annual costs decline remarkably, and cadaveric TX is less costly than both dialysis modalities.
Authors:
Tapani Salonen; Tuomo Reina; Heikki Oksa; Harri Sintonen; Amos Pasternack
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  42     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-05     Completed Date:  2004-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1228-38     Citation Subset:  IM    
Affiliation:
Medical School, University of Tampere, Tampere, Finland. tapani.salonen@uta.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cadaver
Comorbidity
Costs and Cost Analysis
Drug Costs
Female
Finland
Health Care Costs
Health Resources / economics,  utilization
Health Services / economics,  utilization
Hospital Costs
Humans
Kidney Failure, Chronic / economics,  mortality,  therapy
Kidney Transplantation / economics,  statistics & numerical data
Life Tables
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory / economics,  statistics & numerical data
Renal Dialysis / economics,  statistics & numerical data
Renal Replacement Therapy / economics*,  statistics & numerical data
Retrospective Studies
Survival Analysis
Transportation of Patients / economics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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