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Understanding cost of care for patients on renal replacement therapy: looking beyond fixed tariffs.
- Source :
- Nephrology Dialysis Transplantation; Oct2015, Vol. 30 Issue 10, p1726-1734, 9p, 5 Charts
- Publication Year :
- 2015
-
Abstract
- Background. In a number of countries, reimbursement to hospitals providing renal dialysis services is set according to a fixed tariff. While the cost of maintenance dialysis and transplant surgery are amenable to a system of fixed tariffs, patients with established renal failure commonly present with comorbid conditions that can lead to variations in the need for hospitalization beyond the provision of renal replacement therapy. Methods. Patient-level cost data for incident renal replacement therapy patients in England were obtained as a result of linkage of the Hospital Episodes Statistics dataset to UK Renal Registry data. Regression models were developed to explore variations in hospital costs in relation to treatment modality, number of years on treatment and factors such as age and comorbidities. The final models were then used to predict annual costs for patients with different sets of characteristics. Results. Excluding the cost of renal replacement therapy itself, inpatient costs generally decreased with number of years on treatment for haemodialysis and transplant patients, whereas costs for patients receiving peritoneal dialysis remained constant. Diabetes was associated with higher mean annual costs for all patients irrespective of treatment modality and hospital setting. Age did not have a consistent effect on costs. Conclusions. Combining predicted hospital costs with the fixed costs of renal replacement therapy showed that the total cost differential for a patient continuing on dialysis rather than receiving a transplant is considerable following the first year of renal replacement therapy, thus reinforcing the longer- term economic advantage of transplantation over dialysis for the health service. [ABSTRACT FROM AUTHOR]
- Subjects :
- KIDNEY transplantation
HOSPITAL costs
COMORBIDITY
MEDICAL care costs
HOSPITAL care
Subjects
Details
- Language :
- English
- ISSN :
- 09310509
- Volume :
- 30
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Nephrology Dialysis Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 109538010
- Full Text :
- https://doi.org/10.1093/ndt/gfv224