Healthcare costs in chronic kidney disease and renal replacement therapy: a population-based cohort study in Sweden.
Healthcare costs in chronic kidney disease and renal replacement therapy: a population-based cohort study in Sweden.
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DOI：
10.1136/bmjopen-2016-012062
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发表时间：
2016-10-07
期刊：
影响因子：
2.9
通讯作者：
Hylander B
中科院分区：
文献类型：
--
作者：
Eriksson JK;Neovius M;Jacobson SH;Elinder CG;Hylander B
比较非透析(估计肾小球滤过率为30 毫升/分钟/1.73m2)、腹膜透析、血液透析的慢性肾脏病4期或5期患者的医疗费用，以及使用匹配的普通人群比较指标的移植患者的医疗费用。基于人群的队列研究。瑞典国家医疗系统。2010年1月1日斯德哥尔摩国家肾脏病临床质量登记处公布了流行的成人慢性肾脏病4~5岁(n=1046，平均年龄68 )、腹膜透析(n=101； 岁)、血液透析(n=460；65 )和肾移植(n=825；52 )患者。按年龄、性别和指数年将来自同一县的5名普通人群对照人员配对。2009年的年度医疗费用是通过住院和以医院为基础的门诊护理以及从全国医疗登记中确定的处方药物产生的。次要结果是每年住院天数和门诊就诊次数。血液透析患者的年平均费用最高(欧元87 600)，是腹膜透析患者(欧元58 600)的1.49倍(95%可信区间1.38至1.60)。移植患者的年平均费用(15 500欧元)和慢性肾脏病组(9 600欧元)要低得多。在血液透析患者中，门诊护理费用占总费用的三分之二以上(62 500欧元)，而与液体有关的费用(29 900美元)是腹膜透析患者(51%)的最大成本组成部分。血液透析患者、腹膜透析患者、移植患者和慢性肾脏病患者的年平均费用(95%CI)分别为45(39~51)、29(22~37)、11(10~13)和4.0(3.6~4.5)倍。血液透析患者的年平均费用比腹膜透析患者高出∼50%。与普通人群相比，所有组的费用都大幅上升，从慢性肾脏病患者的4倍增加到移植患者以及腹膜透析和血液透析患者的11、29和45倍。
To compare healthcare costs in chronic kidney disease (CKD) stage 4 or 5 not on dialysis (estimated glomerular filtration rate <30 mL/min/1.73m2), peritoneal dialysis, haemodialysis and in transplanted patients with matched general population comparators. Population-based cohort study. Swedish national healthcare system. Prevalent adult patients with CKD 4 or 5 (n=1046, mean age 68 years), on peritoneal dialysis (n=101; 64 years), on haemodialysis (n=460; 65 years) and with renal transplants (n=825; 52 years) were identified in Stockholm County clinical quality registers for renal disease on 1 January 2010. 5 general population comparators from the same county were matched to each patient by age, sex and index year. Annual healthcare costs in 2009 incurred through inpatient and hospital-based outpatient care and dispensed prescription drugs ascertained from nationwide healthcare registers. Secondary outcomes were annual number of hospital days and outpatient care visits. Patients on haemodialysis had the highest mean annual cost (€87 600), which was 1.49 (95% CI 1.38 to 1.60) times that observed in peritoneal dialysis (€58 600). The mean annual cost was considerably lower in transplanted patients (€15 500) and in the CKD group (€9600). In patients on haemodialysis, outpatient care costs made up more than two-thirds (€62 500) of the total, while costs related to fluids ($29 900) was the largest cost component in patients on peritoneal dialysis (51%). Compared with their matched general population comparators, the mean annual cost (95% CI) in patients on haemodialysis, peritoneal dialysis, transplanted patients and patients with CKD was 45 (39 to 51), 29 (22 to 37), 11 (10 to 13) and 4.0 (3.6 to 4.5) times higher, respectively. The mean annual costs were ∼50% higher in patients on haemodialysis than in those on peritoneal dialysis. Compared with the general population, costs were substantially elevated in all groups, from 4-fold in patients with CKD to 11, 29 and 45 times higher in transplanted patients and patients on peritoneal dialysis and haemodialysis, respectively.
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影响因子：
--
作者：
Thompson, SG;Barber, JA
通讯作者：
Barber, JA
DOI：
10.1097/01.asn.0000125670.64996.bb
发表时间：
2004-05-01
影响因子：
13.6
作者：
Smith, DH;Gullion, CM;Brown, JB
通讯作者：
Brown, JB
影响因子：
5.5
作者：
通讯作者：
--
影响因子：
4.2
作者：
Baumeister, Sebastian E.;Boeger, Carsten A.;Meisinger, Christa
通讯作者：
Meisinger, Christa
影响因子：
13.6
作者：
Honeycutt, Amanda A.;Segel, Joel E.;Williams, Desmond
通讯作者：
Williams, Desmond