Healthcare costs of patients on different renal replacement modalities - Analysis of Dutch health insurance claims data
Healthcare costs of patients on different renal replacement modalities - Analysis of Dutch health insurance claims data
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DOI：
10.1371/journal.pone.0220800
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发表时间：
2019-08-15
期刊：
影响因子：
3.7
通讯作者：
de Wit, G. Ardine
中科院分区：
文献类型：
--
作者：
Mohnen, Sigrid M.;van Oosten, Manon J. M.;de Wit, G. Ardine
背景本研究的目的是展示荷兰肾脏替代治疗 (RRT) 患者 7 种治疗方式的平均年度医疗费用。方法使用 2012-2014 年的健康保险索赔数据。选择了 2014 年要求透析或肾移植的所有患者。分析了 5 种透析方式（中心血液透析 (CHD)、家庭血液透析 (HHD)、连续门诊腹膜透析 (CAPD)、自动腹膜透析 (APD) 和一年内多种透析方式（混合组））和 2 种移植方式（来自活体和已故捐赠者的肾脏，结果 2014 年，CAPD 患者的年平均医疗费用总额为 (sic)77,566 (SD = (sic)27,237)，混合组患者为 (sic)105,833 (SD = (sic)30,239)。对于所有透析方式，绝大多数 (72-84%) 成本与 RRT 相关。与每周透析 3 次的患者相比，每周进行 4 次以上血液透析的患者的平均年费用显着更高 (Delta(sic)19,122）。肾移植受者的移植当年费用为 (sic)85,127 (SD = (sic)39,679)，并在移植成功后的第一年和第二年迅速下降（分别为 (sic)29,612 (SD = (sic)34,099) 和 (sic)15,018 (SD = (sic)16,186))。与活体供体肾移植 ((sic)73,376，SD = (sic)38,666) 相比，移植当年的死亡供体肾移植费用更高 ((sic)99,450，SD = (sic)36,036))。 结论 与其他透析方式相比，CAPD 患者的费用最低。使用活体捐赠者肾脏的患者与已故捐赠者相比，移植当年的费用要低 25%。移植成功后，每年的费用大幅下降至每年透析费用的约 14-19%。
BackgroundThe aim of this study is to present average annual healthcare costs for Dutch renal replacement therapy (RRT) patients for 7 treatment modalities.MethodsHealth insurance claims data from 2012-2014 were used. All patients with a 2014 claim for dialysis or kidney transplantation were selected. The RRT related and RRT unrelated average annual healthcare costs were analysed for 5 dialysis modalities (in-centre haemodialysis (CHD), home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and multiple dialysis modalities in a year (Mix group)) and 2 transplant modalities (kidney from living and deceased donor, respectively).ResultsThe total average annual healthcare costs in 2014 ranged from (sic)77,566 (SD = (sic)27,237) for CAPD patients to (sic)105,833 (SD = (sic)30,239) for patients in the Mix group. For all dialysis modalities, the vast majority (72-84%) of costs was RRT related. Patients on haemodialysis >= 4x/week had significantly higher average annual costs compared to those dialyzing 3x/week (Delta(sic)19,122). Costs for kidney transplant recipients were (sic)85,127 (SD = (sic)39,679) in the year of transplantation and rapidly declined in the first and second year after successful transplantation (resp. (sic)29,612 (SD = (sic)34,099) and (sic)15,018 (SD = (sic)16,186)). Transplantation with a deceased donor kidney resulted in higher costs ((sic)99,450, SD = (sic)36,036)) in the year of transplantation compared to a living donor kidney transplantation ((sic)73,376, SD = (sic)38,666).ConclusionsCAPD patients have the lowest costs compared to other dialysis modalities. Costs in the year of transplantation are 25% lower for patients with kidneys from living vs. deceased donor. After successful transplantation, annual costs decline substantially to a level that is approximately 14-19% of annual dialysis costs.