Shukri, Arim; Mettang, Thomas; Scheckel, Benjamin; Schellartz, Isabell; Simic, Dusan; Scholten, Nadine; Müller, Martin; Stock, Stephanie (2022). Hemodialysis and Peritoneal Dialysis in Germany from a Health Economic View-A Propensity Score Matched Analysis. International journal of environmental research and public health, 19(21) MDPI 10.3390/ijerph192114007
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BACKGROUND
Hemodialysis (HD) and peritoneal dialysis (PD) are deemed medically equivalent for therapy of end-stage renal disease (ESRD) and reimbursed by the German statutory health insurance (SHI). However, although the home dialysis modality PD is associated with higher patient autonomy than HD, for unknown reasons, PD uptake is low in Germany. Hence, we compared HD with PD regarding health economic outcomes, particularly costs, as potentially relevant factors for the predominance of HD.
METHODS
Claims data from two German health insurance funds were analysed in a retrospective cohort study regarding the prevalence of HD and PD in 2013-2016. Propensity score matching created comparable HD and PD groups (n = 436 each). Direct annual health care costs were compared. A sensitivity analysis included a comparison of different matching techniques and consideration of transportation costs. Additionally, hospitalisation and survival were investigated using Poisson regression and Kaplan-Meier curves.
RESULTS
Total direct annual average costs were higher for HD (€47,501) than for PD (€46,235), but not significantly (p = 0.557). The additional consideration of transportation costs revealed an annual cost advantage of €7000 for PD. HD and PD differed non-significantly in terms of hospitalisation and survival rates (p = 0.610/p = 0.207).
CONCLUSIONS
PD has a slight non-significant cost advantage over HD, especially when considering transportation costs.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center |
UniBE Contributor: |
Müller, Martin (B) |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1660-4601 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
17 Nov 2022 13:15 |
Last Modified: |
29 Mar 2023 23:38 |
Publisher DOI: |
10.3390/ijerph192114007 |
PubMed ID: |
36360885 |
Uncontrolled Keywords: |
ESRD German statutory health insurance claims data costs hemodialysis peritoneal dialysis propensity score |
BORIS DOI: |
10.48350/174762 |
URI: |
https://boris.unibe.ch/id/eprint/174762 |
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