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Article: Direct and indirect costs of end-stage renal disease patients in the first and second years after initiation of nocturnal home haemodialysis, hospital haemodialysis and peritoneal dialysis

TitleDirect and indirect costs of end-stage renal disease patients in the first and second years after initiation of nocturnal home haemodialysis, hospital haemodialysis and peritoneal dialysis
Authors
KeywordsDialysis
Economic burden
End-stage renal disease
Micro-costing
Nocturnal home haemodialysis
Issue Date2019
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2019 How to Cite?
AbstractPurpose: To estimate the direct and indirect costs of end-stage renal disease (ESRD) patients in the first and second years of initiating peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. Methods: A cost analysis was performed to estimate the annual costs of PD, hospital-based HD and nocturnal home HD for ESRD patients from both the health service provider and societal perspectives. Empirical data on healthcare resource use, patients’ out-of-pocket costs, time spent on transportation and dialysis by ESRD patients, and time spent by caregivers were analysed. All costs were expressed in Hong Kong year 2017 dollars. Results: Analysis was based on 402 ESRD patients on maintenance dialysis (PD: 189; hospital-based HD: 170; and nocturnal home HD: 43). From the perspective of healthcare provider, hospital-based HD had the highest total annual direct medical costs in initial year (Hospital-based HD = $400,057±62,822; PD = $118,467±15,559; Nocturnal home HD = $223,358±18,055; p<0.001) and second year (Hospital-based HD = $360,924±63,014; PD = $80,796±15,820; Nocturnal home HD = $87,028±9,059; p<0.001). From the societal perspective, hospital-based HD had the highest total annual costs in initial year (Hospital-based HD = $452,151±73,327; PD = $189,191±61,735; Nocturnal home HD = $242,038±28,281; p<0.001) and second year (Hospital-based HD = $413,017±73,501; PD = $151,520±60,353; Nocturnal home HD = $105,708±23,853; p<0.001). Conclusions: This study quantified economic burden of ESRD patients, and assessed the annual healthcare and societal costs in the initial and second years of PD, hospital-based HD and nocturnal home HD in Hong Kong. From both perspectives, PD is cost-saving relative to hospital-based HD and nocturnal home HD, except that nocturnal home HD has the lowest cost in second year of treatment from the societal perspective. Results from this cost analysis facilitate economic evaluation in Hong Kong for health services and management targeted at ESRD patients.
Persistent Identifierhttp://hdl.handle.net/10722/266014
ISSN
2017 Impact Factor: 4.602
2015 SCImago Journal Rankings: 1.780

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorChen, JY-
dc.contributor.authorFung, SKS-
dc.contributor.authorMok, MY-
dc.contributor.authorCheng, YL-
dc.contributor.authorKong, I-
dc.contributor.authorLo, WK-
dc.contributor.authorLui, SL-
dc.contributor.authorChan, DTM-
dc.contributor.authorLam, CLK-
dc.date.accessioned2018-12-17T02:16:32Z-
dc.date.available2018-12-17T02:16:32Z-
dc.date.issued2019-
dc.identifier.citationNephrology Dialysis Transplantation, 2019-
dc.identifier.issn0931-0509-
dc.identifier.urihttp://hdl.handle.net/10722/266014-
dc.description.abstractPurpose: To estimate the direct and indirect costs of end-stage renal disease (ESRD) patients in the first and second years of initiating peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. Methods: A cost analysis was performed to estimate the annual costs of PD, hospital-based HD and nocturnal home HD for ESRD patients from both the health service provider and societal perspectives. Empirical data on healthcare resource use, patients’ out-of-pocket costs, time spent on transportation and dialysis by ESRD patients, and time spent by caregivers were analysed. All costs were expressed in Hong Kong year 2017 dollars. Results: Analysis was based on 402 ESRD patients on maintenance dialysis (PD: 189; hospital-based HD: 170; and nocturnal home HD: 43). From the perspective of healthcare provider, hospital-based HD had the highest total annual direct medical costs in initial year (Hospital-based HD = $400,057±62,822; PD = $118,467±15,559; Nocturnal home HD = $223,358±18,055; p<0.001) and second year (Hospital-based HD = $360,924±63,014; PD = $80,796±15,820; Nocturnal home HD = $87,028±9,059; p<0.001). From the societal perspective, hospital-based HD had the highest total annual costs in initial year (Hospital-based HD = $452,151±73,327; PD = $189,191±61,735; Nocturnal home HD = $242,038±28,281; p<0.001) and second year (Hospital-based HD = $413,017±73,501; PD = $151,520±60,353; Nocturnal home HD = $105,708±23,853; p<0.001). Conclusions: This study quantified economic burden of ESRD patients, and assessed the annual healthcare and societal costs in the initial and second years of PD, hospital-based HD and nocturnal home HD in Hong Kong. From both perspectives, PD is cost-saving relative to hospital-based HD and nocturnal home HD, except that nocturnal home HD has the lowest cost in second year of treatment from the societal perspective. Results from this cost analysis facilitate economic evaluation in Hong Kong for health services and management targeted at ESRD patients.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/-
dc.relation.ispartofNephrology Dialysis Transplantation-
dc.rightsThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in Nephrology Dialysis Transplantation following peer review. The definitive publisher-authenticated version is available online at: http://dx.doi.org/10.1093/ndt/gfy395-
dc.subjectDialysis-
dc.subjectEconomic burden-
dc.subjectEnd-stage renal disease-
dc.subjectMicro-costing-
dc.subjectNocturnal home haemodialysis-
dc.titleDirect and indirect costs of end-stage renal disease patients in the first and second years after initiation of nocturnal home haemodialysis, hospital haemodialysis and peritoneal dialysis-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailChen, JY: juliechen@hku.hk-
dc.identifier.emailMok, MY: mmymok@hku.hk-
dc.identifier.emailLo, WK: wkloc@hkucc.hku.hk-
dc.identifier.emailLui, SL: sllui@hkucc.hku.hk-
dc.identifier.emailChan, DTM: dtmchan@hkucc.hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityChen, JY=rp00526-
dc.identifier.authorityChan, DTM=rp00394-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ndt/gfy395-
dc.identifier.pmid30668781-
dc.identifier.hkuros296381-
dc.publisher.placeUnited Kingdom-
dc.identifier.f1000734903439-

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