Lifetime Costs for Peritoneal Dialysis and Hemodialysis in Patients in Taiwan

Chao

et al. 2015

Sci Rep

Self Cite

Polycystic kidney disease (PCKD) is the most common hereditary cause of end-stage renal disease, the complications of which may prevent the choice of peritoneal dialysis (PD). The aim of this study was to explore the effects of dialysis modality on outcomes in patients with PCKD. We extracted a cohort of 1417 adult patients with PCKD initiating long-term dialysis therapy in 1999–2010 from the Taiwan National Health Insurance Research Database, among which 125 patients chose PD. The patients on HD were older and had a higher comorbidity index compared to those on PD. We compared the risks for death, hospitalization and medical expenditures between the patients on PD and propensity-score matched patients on hemodialysis (HD). The overall survival did not differ between the patients on PD and HD. The patients on PD tended to have higher hazard ratios (HR) for the first episode of hospitalization (adjusted HR 1.34 [95% CI, 1.04−1.79]). The annual medical expenses were 10% lower for the patients on PD. PD is an equivalent choice of renal replacement therapy to HD for patients with PCKD in terms of survival. Although the patients on PD had a higher risk for hospitalization, the medical expenditure for PD was 10% lower.

Section: Discussionsupporting

confidence: 83%

Comparative Study of Outcomes among Patients with Polycystic Kidney Disease on Hemodialysis and Peritoneal Dialysis

Yang

Chao

et al. 2015

Sci Rep

Self Cite

“…In Taiwan, the life expectancies of peritoneal and hemodialysis patients after the start of dialysis were reported to be 7.9 years and 8.7 years, respectively [34], and the annual mortality rate of dialysis patients is around 15% [35]. Sakalkale et al [9] recommended that joint arthroplasty should be reserved for individuals with a long life expectancy.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Complications of Total Knee Arthroplasty in Dialysis Patients

Yen

The Journal of Arthroplasty

et al. 2018

“…By 2017, the cost of dialysis (new Taiwan dollars, NTD, 36.9 billion; 1 US dollar=30 NTD in December 2017) accounted for a staggering 5.73% of the total annual NHI expenditure (NTD 644.1 billion) 3. Haemodialysis (HD) and peritoneal dialysis (PD) are the two major renal replacement modalities in Taiwan with a similar all-cause mortality rate 4–7. Several studies have provided clear evidence that HD has higher direct medical costs among the two modalities 8–14.…”

Section: Introductionmentioning

confidence: 99%

Out-of-pocket costs and productivity losses in haemodialysis and peritoneal dialysis from a patient interview survey in Taiwan

Tang

et al. 2019

BMJ Open

ObjectivesThe total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan.Design and settingThis multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis.Outcome measuresDifferences in OOP costs and productivity losses.ResultsThere were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient–month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively.ConclusionsThe HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.