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Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden

BACKGROUND: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. METHOD: A before–after design was used, in which the patients served...

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Autores principales: Jarl, Johan, Desatnik, Peter, Peetz Hansson, Ulrika, Prütz, Karl Göran, Gerdtham, Ulf-G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888588/
https://www.ncbi.nlm.nih.gov/pubmed/29644072
http://dx.doi.org/10.1093/ckj/sfx088
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author Jarl, Johan
Desatnik, Peter
Peetz Hansson, Ulrika
Prütz, Karl Göran
Gerdtham, Ulf-G
author_facet Jarl, Johan
Desatnik, Peter
Peetz Hansson, Ulrika
Prütz, Karl Göran
Gerdtham, Ulf-G
author_sort Jarl, Johan
collection PubMed
description BACKGROUND: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. METHOD: A before–after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression. RESULTS: Altogether 66–79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample. CONCLUSION: Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy.
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spelling pubmed-58885882018-04-11 Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden Jarl, Johan Desatnik, Peter Peetz Hansson, Ulrika Prütz, Karl Göran Gerdtham, Ulf-G Clin Kidney J Transplantation BACKGROUND: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. METHOD: A before–after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression. RESULTS: Altogether 66–79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample. CONCLUSION: Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy. Oxford University Press 2018-04 2017-08-07 /pmc/articles/PMC5888588/ /pubmed/29644072 http://dx.doi.org/10.1093/ckj/sfx088 Text en © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Transplantation
Jarl, Johan
Desatnik, Peter
Peetz Hansson, Ulrika
Prütz, Karl Göran
Gerdtham, Ulf-G
Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title_full Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title_fullStr Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title_full_unstemmed Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title_short Do kidney transplantations save money? A study using a before–after design and multiple register-based data from Sweden
title_sort do kidney transplantations save money? a study using a before–after design and multiple register-based data from sweden
topic Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888588/
https://www.ncbi.nlm.nih.gov/pubmed/29644072
http://dx.doi.org/10.1093/ckj/sfx088
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