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Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis
OBJECTIVES: Taiwan succeeded in raising the proportion of peritoneal dialysis (PD) usage after the National Health Insurance (NHI) payment scheme introduced financial incentives in 2005. This study aims to compare the economic costs between automated PD (APD) and continuous ambulatory PD (CAPD) moda...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372017/ https://www.ncbi.nlm.nih.gov/pubmed/28325860 http://dx.doi.org/10.1136/bmjopen-2016-015067 |
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author | Tang, Chao-Hsiun Wu, Yu-Ting Huang, Siao-Yuan Chen, Hsi-Hsien Wu, Ming-Ju Hsu, Bang-Gee Tsai, Jer-Chia Chen, Tso-Hsiao Sue, Yuh-Mou |
author_facet | Tang, Chao-Hsiun Wu, Yu-Ting Huang, Siao-Yuan Chen, Hsi-Hsien Wu, Ming-Ju Hsu, Bang-Gee Tsai, Jer-Chia Chen, Tso-Hsiao Sue, Yuh-Mou |
author_sort | Tang, Chao-Hsiun |
collection | PubMed |
description | OBJECTIVES: Taiwan succeeded in raising the proportion of peritoneal dialysis (PD) usage after the National Health Insurance (NHI) payment scheme introduced financial incentives in 2005. This study aims to compare the economic costs between automated PD (APD) and continuous ambulatory PD (CAPD) modalities from a societal perspective. DESIGN AND SETTING: A retrospective cohort of patients receiving PD from the NHI Research Database was identified during 2004–2011. The 1:1 propensity score matched 1749 APD patients and 1749 CAPD patients who were analysed on their NHI-financed medical costs and utilisation. A multicentre study by face-to-face interviews on 117 APD and 129 CAPD patients from five hospitals located in four regions of Taiwan was further carried out to collect data on their out-of-pocket payments, productivity losses and quality of life with EuroQol-5D-5L. OUTCOME MEASURES: The NHI-financed medical costs, out-of-pocket payments and productivity losses of APD and CAPD patients. RESULTS: The total NHI-financed medical costs per patient-year after 5 years of follow-up were significantly higher with APD than CAPD (US$23 005 vs US$19 237; p<0.01). In terms of dialysis-related costs, APD had higher costs resulting from the use of APD machines (US$795) and APD sets (US$2913). Significantly lower productivity losses were found with APD (US$2619) than CAPD (US$6443), but the out-of-pocket payments were not significantly different. The differences in NHI-financed medical costs and productivity losses between APD and CAPD remained robust in the bootstrap analysis. The total economic costs of APD (US$30 401) were similar to those of CAPD (US$29 939), even after bootstrap analysis (APD, US$28 399; CAPD, US$27 960). No discernable differences were found in the results of mortality and quality of life between the APD and CAPD patients. CONCLUSIONS: APD had higher annual dialysis-related costs and lower annual productivity losses than CAPD, which made the economic costs of APD very close to those of CAPD in Taiwan. |
format | Online Article Text |
id | pubmed-5372017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-53720172017-04-12 Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis Tang, Chao-Hsiun Wu, Yu-Ting Huang, Siao-Yuan Chen, Hsi-Hsien Wu, Ming-Ju Hsu, Bang-Gee Tsai, Jer-Chia Chen, Tso-Hsiao Sue, Yuh-Mou BMJ Open Health Economics OBJECTIVES: Taiwan succeeded in raising the proportion of peritoneal dialysis (PD) usage after the National Health Insurance (NHI) payment scheme introduced financial incentives in 2005. This study aims to compare the economic costs between automated PD (APD) and continuous ambulatory PD (CAPD) modalities from a societal perspective. DESIGN AND SETTING: A retrospective cohort of patients receiving PD from the NHI Research Database was identified during 2004–2011. The 1:1 propensity score matched 1749 APD patients and 1749 CAPD patients who were analysed on their NHI-financed medical costs and utilisation. A multicentre study by face-to-face interviews on 117 APD and 129 CAPD patients from five hospitals located in four regions of Taiwan was further carried out to collect data on their out-of-pocket payments, productivity losses and quality of life with EuroQol-5D-5L. OUTCOME MEASURES: The NHI-financed medical costs, out-of-pocket payments and productivity losses of APD and CAPD patients. RESULTS: The total NHI-financed medical costs per patient-year after 5 years of follow-up were significantly higher with APD than CAPD (US$23 005 vs US$19 237; p<0.01). In terms of dialysis-related costs, APD had higher costs resulting from the use of APD machines (US$795) and APD sets (US$2913). Significantly lower productivity losses were found with APD (US$2619) than CAPD (US$6443), but the out-of-pocket payments were not significantly different. The differences in NHI-financed medical costs and productivity losses between APD and CAPD remained robust in the bootstrap analysis. The total economic costs of APD (US$30 401) were similar to those of CAPD (US$29 939), even after bootstrap analysis (APD, US$28 399; CAPD, US$27 960). No discernable differences were found in the results of mortality and quality of life between the APD and CAPD patients. CONCLUSIONS: APD had higher annual dialysis-related costs and lower annual productivity losses than CAPD, which made the economic costs of APD very close to those of CAPD in Taiwan. BMJ Publishing Group 2017-03-21 /pmc/articles/PMC5372017/ /pubmed/28325860 http://dx.doi.org/10.1136/bmjopen-2016-015067 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Health Economics Tang, Chao-Hsiun Wu, Yu-Ting Huang, Siao-Yuan Chen, Hsi-Hsien Wu, Ming-Ju Hsu, Bang-Gee Tsai, Jer-Chia Chen, Tso-Hsiao Sue, Yuh-Mou Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title | Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title_full | Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title_fullStr | Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title_full_unstemmed | Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title_short | Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis |
title_sort | economic costs of automated and continuous ambulatory peritoneal dialysis in taiwan: a combined survey and retrospective cohort analysis |
topic | Health Economics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372017/ https://www.ncbi.nlm.nih.gov/pubmed/28325860 http://dx.doi.org/10.1136/bmjopen-2016-015067 |
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