Economic Burden and Medical Insurance Impact of the Different Dialysis for End-stage Renal Diseases

BACKGROUND: Dialysis costs was a heavy burden in End Stage Renal Disease (ESRD) patients. In China, the two major medical insurance systems are the New Cooperative Medical Scheme (NCMS) for rural residents and the Urban Employees’ Medical Insurance (UEMI) for urban patients. This study compared the economic burden of ESRD patients under different dialysis methods and the impact of the medical insurance system on it. METHODS: Overall, 156 ESRD patients were enrolled at the Department of Nephrology in the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China between Jan 2013 and Jan 2014. They were divided into hemodialysis group (HD group, n=84) and peritoneal dialysis group (PD group, n=72). The data, such as the patient’s basic information, total expenses and self-paid expenses in the early stage of dialysis and 1-year treatment, and medical insurance type, were separately collected. RESULTS: The early-stage average total expenses and self-paid expenses in the PD group were higher than those in the HD group (P<0.01). The average total expenses and self-paid expenses in the PD group were lower than those in the HD group (P<0.01). Whichever dialysis method was used, the self-paid expense percentage for the NCMS patients and was higher than UEMI patients. CONCLUSION: In terms of the long-term dialysis treatment for ESRD patients, the better choice was PD judging by the treatment expenses. Meanwhile, different medical insurance types had significant economic burden impacts on dialysis patients.