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Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States
Patients presenting late in the course of kidney disease who require urgent initiation of dialysis have traditionally received temporary vascular catheters followed by hemodialysis. Recent changes in Medicare payment policy for dialysis in the USA incentivized the use of peritoneal dialysis (PD). Co...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603112/ https://www.ncbi.nlm.nih.gov/pubmed/25526471 http://dx.doi.org/10.1097/MD.0000000000000293 |
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author | Liu, Frank Xiaoqing Ghaffari, Arshia Dhatt, Harman Kumar, Vijay Balsera, Cristina Wallace, Eric Khairullah, Quresh Lesher, Beth Gao, Xin Henderson, Heather LaFleur, Paula Delgado, Edna M. Alvarez, Melissa M. Hartley, Janett McClernon, Marilyn Walton, Surrey Guest, Steven |
author_facet | Liu, Frank Xiaoqing Ghaffari, Arshia Dhatt, Harman Kumar, Vijay Balsera, Cristina Wallace, Eric Khairullah, Quresh Lesher, Beth Gao, Xin Henderson, Heather LaFleur, Paula Delgado, Edna M. Alvarez, Melissa M. Hartley, Janett McClernon, Marilyn Walton, Surrey Guest, Steven |
author_sort | Liu, Frank Xiaoqing |
collection | PubMed |
description | Patients presenting late in the course of kidney disease who require urgent initiation of dialysis have traditionally received temporary vascular catheters followed by hemodialysis. Recent changes in Medicare payment policy for dialysis in the USA incentivized the use of peritoneal dialysis (PD). Consequently, the use of more expeditious PD for late-presenting patients (urgent-start PD) has received new attention. Urgent-start PD has been shown to be safe and effective, and offers a mechanism for increasing PD utilization. However, there has been no assessment of the dialysis-related costs over the first 90 days of care. The objective of this study was to characterize the costs associated with urgent-start PD, urgent-start hemodialysis (HD), or a dual approach (urgent-start HD followed by urgent-start PD) over the first 90 days of treatment from a provider perspective. A survey of practitioners from 5 clinics known to use urgent-start PD was conducted to provide inputs for a cost model representing typical patients. Model inputs were obtained from the survey, literature review, and available cost data. Sensitivity analyses were also conducted. The estimated per patient cost over the first 90 days for urgent-start PD was $16,398. Dialysis access represented 15% of total costs, dialysis services 48%, and initial hospitalization 37%. For urgent-start HD, total per patient costs were $19,352, and dialysis access accounted for 27%, dialysis services 42%, and initial hospitalization 31%. The estimated cost for dual patients was $19,400. Urgent-start PD may offer a cost saving approach for the initiation of dialysis in eligible patients requiring an urgent-start to dialysis. |
format | Online Article Text |
id | pubmed-4603112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-46031122015-10-27 Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States Liu, Frank Xiaoqing Ghaffari, Arshia Dhatt, Harman Kumar, Vijay Balsera, Cristina Wallace, Eric Khairullah, Quresh Lesher, Beth Gao, Xin Henderson, Heather LaFleur, Paula Delgado, Edna M. Alvarez, Melissa M. Hartley, Janett McClernon, Marilyn Walton, Surrey Guest, Steven Medicine (Baltimore) 5200 Patients presenting late in the course of kidney disease who require urgent initiation of dialysis have traditionally received temporary vascular catheters followed by hemodialysis. Recent changes in Medicare payment policy for dialysis in the USA incentivized the use of peritoneal dialysis (PD). Consequently, the use of more expeditious PD for late-presenting patients (urgent-start PD) has received new attention. Urgent-start PD has been shown to be safe and effective, and offers a mechanism for increasing PD utilization. However, there has been no assessment of the dialysis-related costs over the first 90 days of care. The objective of this study was to characterize the costs associated with urgent-start PD, urgent-start hemodialysis (HD), or a dual approach (urgent-start HD followed by urgent-start PD) over the first 90 days of treatment from a provider perspective. A survey of practitioners from 5 clinics known to use urgent-start PD was conducted to provide inputs for a cost model representing typical patients. Model inputs were obtained from the survey, literature review, and available cost data. Sensitivity analyses were also conducted. The estimated per patient cost over the first 90 days for urgent-start PD was $16,398. Dialysis access represented 15% of total costs, dialysis services 48%, and initial hospitalization 37%. For urgent-start HD, total per patient costs were $19,352, and dialysis access accounted for 27%, dialysis services 42%, and initial hospitalization 31%. The estimated cost for dual patients was $19,400. Urgent-start PD may offer a cost saving approach for the initiation of dialysis in eligible patients requiring an urgent-start to dialysis. Wolters Kluwer Health 2014-12-02 /pmc/articles/PMC4603112/ /pubmed/25526471 http://dx.doi.org/10.1097/MD.0000000000000293 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 5200 Liu, Frank Xiaoqing Ghaffari, Arshia Dhatt, Harman Kumar, Vijay Balsera, Cristina Wallace, Eric Khairullah, Quresh Lesher, Beth Gao, Xin Henderson, Heather LaFleur, Paula Delgado, Edna M. Alvarez, Melissa M. Hartley, Janett McClernon, Marilyn Walton, Surrey Guest, Steven Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title | Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title_full | Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title_fullStr | Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title_full_unstemmed | Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title_short | Economic Evaluation of Urgent-Start Peritoneal Dialysis Versus Urgent-Start Hemodialysis in the United States |
title_sort | economic evaluation of urgent-start peritoneal dialysis versus urgent-start hemodialysis in the united states |
topic | 5200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603112/ https://www.ncbi.nlm.nih.gov/pubmed/25526471 http://dx.doi.org/10.1097/MD.0000000000000293 |
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