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

Tang, Chao Hsiun; Chen, Hsi Hsien; Wu, Ming; Hsu, Bang Gee; Tsai, Jason; Kuo, C; Lin, Shih Pi; Chen, Tso Hsiao; Sue, Yuh Mou

doi:10.1136/bmjopen-2018-023062

Cited by 16 publications

(20 citation statements)

References 19 publications

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“…This is a universal scenario as HD patients often require an early retirement or sacrifice their employment or job opportunities to fit in the HD schedule [ 37 , 38 ]. Loss of productivity due to unemployment among HD patients had been reported to be higher compared to peritoneal dialysis [ 39 , 40 ], besides reduced quality of life attributed to the necessity for frequent travel.…”

Section: Discussionmentioning

confidence: 99%

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Wong

Kamaruddin

et al. 2020

IJERPH

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Despite optimal control of serum phosphate level being imperative to avoid undesirable health outcomes, hyperphosphataemia is a highly prevalent mineral abnormality among the dialysis population. This study aimed to determine factors associated with hyperphosphatemia among hemodialysis patients in Malaysia. Multiple linear regression analysis was used to ascertain the possible factors that influence serum phosphate levels. A total of 217 hemodialysis patients were recruited. Hyperphosphatemia was prevalent. Only approximately 25% of the patients were aware that optimal control of hyperphosphatemia requires the combined effort of phosphate binder medication therapy, dietary restriction, and dialysis prescription. The presence of diabetes mellitus may affect serum phosphate levels, complicating dietary phosphorus management. Patients who were less depressive portrayed higher serum phosphate levels, implying intentional non-compliance. Better compliance on phosphate binder, longer sleep duration, and higher social support was associated with a lower level of serum phosphate. Despite sleep disturbance being one of the most prevalent and intense symptom burdens identified by hemodialysis patients, relatively few studies have addressed this issue. It is time to formulate sleep therapeutic interventions besides the encouragement of strong social support, hoping which many clinical outcomes including hyperphosphatemia can be better controlled among hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Wong

Kamaruddin

et al. 2020

IJERPH

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“…Patients receiving hospital-based hemodialysis pay higher healthcare and societal costs than peritoneal dialysis patients [ 2 , 7 , 8 , 9 , 10 , 11 ], and general patients [ 10 ]. The cost of hemodialysis treatment has increased over time [ 12 ], even though hemodialysis patients have a poorer health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) than peritoneal dialysis patients [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Doan

Nguyen

et al. 2020

IJERPH

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We examined factors associated with healthcare cost, health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) in hemodialysis patients. We conducted a cross-sectional study on 160 patients from January to April 2019 at a hemodialysis center. Socio-demographic, clinical, and laboratory parameters and quality of life (QOL) (using KDQOL-SF-v1.3) were assessed. Monthly healthcare costs were extracted from the hospital information system. The means of healthcare cost, HRQOL, and KDQOL were VND 9.4 ± 1.6 million, VND 45.1 ± 21.9 and VND 51.3 ± 13.0, respectively. In the multivariate analysis, the healthcare cost was higher in patients with a longer hemodialysis vintage (regression coefficient (B): 0.74; 95% confidence interval (95% CI): 0.25; 1.23), comorbidity (B: 0.77; 95% CI: 0.24; 1.31); and lower in those with a higher hematocrit concentration (B: −0.07; 95% CI: −0.13; −0.01). Patients that lived in urban areas (B: 9.08; 95% CI: 2.30; 15.85) had a better HRQOL; those with a comorbidity (B: −14.20; 95% CI: −21.43; −6.97), and with hypoalbuminemia (B: −9.31; 95% CI: −16.58; −2.04) had a poorer HRQOL. Patients with a higher level of education (B: 5.38~6.29) had a better KDQOL; those with a comorbidity had a poorer KDQOL (B: −6.17; 95% CI: −10.49; −1.85). In conclusion, a longer hemodialysis vintage, a comorbidity and a lower hematocrit concentration were associated with higher healthcare costs. Patients who lived in urban areas had a better HRQOL and a higher level of education led to a better KDQOL. Patients with a comorbidity had a lower HRQOL and KDQOL. Malnourished patients had a lower HRQOL.

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“…In the same year, the cost of dialysis was 1.23 billion US dollars, accounting for a staggering 5.73% of the total annual NHI expenditure in Taiwan. 3 The costs of providing care for end-stage renal disease (ESRD) patients are especially high, as Taiwan has the highest incidence and prevalence rates of ESRD in the world. 4 The US Renal Data System (USRDS) Annual Report published the latest global uremia rankings.…”

Section: Introductionmentioning

confidence: 99%

Health Data-Driven Machine Learning Algorithms Applied to Risk Indicators Assessment for Chronic Kidney Disease

Chiu¹,

Jhou²,

Lee³

et al. 2021

RMHP

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Purpose: As global aging progresses, the health management of chronic diseases has become an important issue of concern to governments. Influenced by the aging of its population and improvements in the medical system and healthcare in general, Taiwan's population of patients with chronic kidney disease (CKD) has tended to grow year by year, including the incidence of high-risk cases that pose major health hazards to the elderly and middle-aged populations. Methods: This study analyzed the annual health screening data for 65,394 people from 2010 to 2015 sourced from the MJ Group -a major health screening center in Taiwan -including data for 18 risk indicators. We used five prediction model analysis methods, namely, logistic regression (LR) analysis, C5.0 decision tree (C5.0) analysis, stochastic gradient boosting (SGB) analysis, multivariate adaptive regression splines (MARS), and eXtreme gradient boosting (XGboost), with estimated glomerular filtration rate (e-GFR) data to determine G3a, G3b & G4 stage CKD risk factors. Results: The LR analysis (AUC=0.848), SGB analysis (AUC=0.855), and XGboost (AUC=0.858) generated similar classification performance levels and all outperformed the C5.0 and MARS methods. The study results showed that in terms of CKD risk factors, blood urea nitrogen (BUN) and uric acid (UA) were identified as the first and second most important indicators in the models of all five analysis methods, and they were also clinically recognized as the major risk factors. The results for systolic blood pressure (SBP), SGPT, SGOT, and LDL were similar to those of a related study. Interestingly, however, socioeconomic status-related education was found to be the third important indicator in all three of the better performing analysis methods, indicating that it is more important than the other risk indicators of this study, which had different levels of importance according to the different methods. Conclusion:The five prediction model methods can provide high and similar classification performance in this study. Based on the results of this study, it is recommended that education as the socioeconomic status should be an important factor for CKD, as high educational level showed a negative and highly significant correlation with CKD. The findings of this study should also be of value for further discussions and follow-up research.

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

Cited by 16 publications

References 19 publications

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Health Data-Driven Machine Learning Algorithms Applied to Risk Indicators Assessment for Chronic Kidney Disease

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