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The organization and financing of dialysis and kidney transplantation services in New Zealand

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Abstract

In New Zealand, patients receive treatment for end-stage renal disease (ESRD) within the tax-funded health system. All hospital and specialist outpatient services are free, while general practitioner consultations and pharmaceuticals prescribed outside of hospitals incur copayments. Total ESRD prevalence is 0.07%, half the U.S. rate, and the prevalence of home-based and self-care dialysis is the highest in the world. Medical staff are not subject to direct financial incentives that could affect treatment choice. Estimated total expenditure per ESRD patient is relatively low. Funding constraints encourage physicians and patients to consider the probable benefit of dialysis for a patient before treatment is prescribed.

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References

  • ANZDATA. (2003). Australia and New Zealand Dialysis and Transplant Registry 2003. Adelaide: Australia and New Zealand Dialysis and Transplant Registry.

  • ANZDATA. (2004). Australia and New Zealand Dialysis and Transplant Registry 2004. Adelaide: Australia and New Zealand Dialysis and Transplant Registry.

  • Barany P., Carrera F., Chanard J., Eckardt K.U., Hadjicontantinou V., Leenaerts P., Leunissen M.L., Locatelli F., MacLeod A., Rutkowski B., Sanz D., Schaefer R.M., Schmieder R., Winearls C.G. (1999). European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrology Dialysis and Transplantation 14: 1–50

    Google Scholar 

  • Bremer B.A., McCauley C.R., Wrona R.M., Johnson J.P. (1989). Quality of life in end-stage renal disease: a reexamination. American Journal of Kidney Diseases 13: 200–209

    Google Scholar 

  • Cass A., Cunningham J., Snelling P., Ayanian J.Z. (2003). Late referral to a nephrologist reduces access to renal transplantation. American Journal of Kidney Diseases 42(5): 1043–1049

    Article  Google Scholar 

  • Cass A., Chadban S., Craig J., Howard K., McDonald S., Salkeld G., White S. (2006). The economic impact of end-stage kidney disease in Australia. Sydney, The George Institute for International Health

    Google Scholar 

  • Collins J. (1998). Who should receive dialysis?. New Ethicals Journal 10(8): 13–19

    Google Scholar 

  • Collins J., & Metcalf, P. (2003). Access to dialysis in New Zealand renal services. New Zealand Medical Journal, 116 (1175).

  • Coney S. (1994). Access to renal dialysis in South Auckland. Lancet 344: 675

    Article  Google Scholar 

  • Dor, A., Pauly, M.V., Eichleay, M.A., & Held, P.J. (2007). End-stage renal disease and economic incentives: The International Study of Health Care Organization and Financing (ISHCOF). International Journal of Health Care Finance and Economics DOI: 10.1007/s10754-007-9024-9

  • Health Workforce Advisory Committee (2002). The New Zealand health workforce: A stocktake of issues and capacity 2001. Health Workforce Advisory Committee, Wellington.

  • Jager K.J., Merkus M.P., Boeschoten E.W., Dekker F.W., Tijssen J.G., Krediet R.T., Necosad Study Group. (2001). What happens to patients starting dialysis in the Netherlands. Netherlands Journal of Medicine 58: 163–173

    Article  Google Scholar 

  • Kjellstrand C. (1996). High-technology medicine and the old: the dialysis example. Journal of Internal Medicine 239(3): 195–210

    Article  Google Scholar 

  • Lamping D.L., Constantinovici N., Roderock P., Normand C., Henderson L., Harris S., Brown E., Gruen R., Victor C. (2000). Clinical outcomes, quality of life, and costs in the North Thames Dialysis Study of Elderly People on Dialysis: A prospective cohort study. Lancet 356(9241): 1543–1550

    Article  Google Scholar 

  • Laupacis A., Keown P., Pus N., Krueger H., Ferguson B., Wong C.M., Muirhead N. (1996). A study of the quality of life and cost-utility of renal transplantation. Kidney International 50: 235–242

    Article  Google Scholar 

  • Lynn K.L., Buttimore A.L. (2005). Future of home haemodialysis in Australia and New Zealand. Nephrology 10(3): 231–233

    Article  Google Scholar 

  • McDonald, S., & Russ, G.R. (2002). Chapter 2: New Patients. 25th ANZDATA Registry Report. Adelaide, SA: Australia and New Zealand Dialysis and Transplant Registry.

  • McDonald S., Russ G.R. (2003). Current incidence, treatment patterns and outcome of end-stage renal disease among indigenous groups in Australia and New Zealand. Nephrology 8: 42–48

    Article  Google Scholar 

  • Marshall, M. (2003). Predictors of mortality in haemodialysis patients, Chapter 12 in Australia and New Zealand Dialysis and Transplant Registry (2003) 26th Annual Report, http://www.anzdata.org.au/anzdata/AnzdataReport/download.htm.

  • Ministry of Health. (a). Information about the management referral and assessment guidelines. Retrieved January 5, 2005, at http://www.electiveservices.govt.nz/guidelineinfo.html.

  • Ministry of Health. (b). Waiting list criteria for renal transplantation. Retrieved January 5, 2005, at http://www.electiveservices.govt.nz/renal_transplantation.html.

  • Ministry of Health. (2002). Diabetes in New Zealand: Models and forecasts 1996–2011. Ministry of Health: Wellington, NZ.

  • Ministry of Health. (2003). Population-based funding formula. Retrieved April 4, 2007, at http://www.moh. govt.nz/moh.nsf/49b6bf07a4b7346dcc256fb300005a51/9ec525446f3acc8ccc256e9000125381? OpenDocument

  • Minister of Health. (2004a). Memorandum to cabinet: Primary health care strategy: Achieving low cost access proposal. Retrieved January 5, 2005, at http://www.moh.govt.nz/moh.nsf/0/EC272299ECCBF6E1CC256C4F00028D15/$File/CabinetPaperLowCostAccess.pdf

  • Ministry of Health. (2004b). A picture of health: Key results of the 2003/2003 New Zealand Health Survey. Ministry of Health: Wellington, NZ.

  • Ministry of Health. (2005). Health expenditure trends in New Zealand 1990 - 2003. Ministry of Health: Wellington, NZ. Retrieved April 12, 2007, at http://www.moh.govt.nz/moh.nsf/pagesmh/4405?Open

  • Mowatt G., Vale L., Macleod A. (2004). Systematic review of the effectiveness of home versus hospital or satellite unit hemodialysis for people with end-stage renal failure. International Journal of Technology Assessment in Health Care 20: 258–268

    Google Scholar 

  • National Kidney Foundation. (2001). K/DOQI clinical practice guidelines for anemia of chronic kidney disease, 2000. American Journal of Kidney Diseases 37: S182-S238.

  • New Zealand Court of Appeal. (1997). Between J Shortland, Appellant and Northland Health Limited, Respondent. October/November 1997.

  • New Zealand Immigration Service. (2003). Areas of absolute skill shortage. Retrieved April 4, 2007, at http://glossary.immigration.govt.nz/Areaofabsoluteskillsshortage.htm.

  • Oberley E., Schattell D. (1996). Home hemodialysis: Survival, quality of life, and rehabilitation. Advances in Renal Replacement Therapy 3: 147–153

    Google Scholar 

  • OECD. (2006). Purchasing Power Parities (PPPs) for OECD countries 1980–2005. Paris: Organization for Economic Cooperation and Development. Retrieved February, 2007, at http://www.oecd.org/statisticsdata/0,2643,en_2649_34357_1_119656_1_1_1,00.html

  • Organ Donation New Zealand. (2005). Organ donation: Facts and figures. Retrieved January 5, 2005 at http://www.donor.co.nz/facts_figures_f_b.html.

  • Pharmac. (2004). Annual Review 2004. Retrieved January 5, 2005 at http://www.pharmac.govt.nz/ pdf/ARev04.pdf.

  • Polkinghorne K.R., McDonald S.P., Marshall M.R., Atkins R.C., Kerr P.G. (2004a). Vascular access practice patterns in the New Zealand haemodialysis population. American Journal of Kidney Diseases 43:696–704

    Article  Google Scholar 

  • Polkinghorne K.R., McDonald S.P., Atkins R.C., Kerr P.G. (2004b). Vascular access and all-cause mortality: a propensity score analysis. Journal of the American Society of Nephrology 15(2):477–86

    Article  Google Scholar 

  • Roake, J. (2002). Gifts of life in short supply. New Zealand Medical Journal, 115(1159).

  • Roake, J. (2004). Dialysis in the elderly. New Zealand Medical Journal, 117(1195).

  • Rubin J., Case G., Bower J. (1990). Comparison of rehabilitation in patients undergoing home hemodialysis: Continuous ambulatory or cyclic peritoneal dialysis vs home hemodialysis. Archives of Internal Medicine 150:1429–1431

    Article  Google Scholar 

  • Saner E., Nitsch D., Descoeudres C., Frey F.J., Uehlinger D.E. (2005). Outcome of home haemodialysis patients: a case-cohort study. Nephrology Dialysis and Transplantation 20:604–610

    Article  Google Scholar 

  • Schoen, C., Osborn, R., Huynh, P.T., Doty, M., Davis, K., Zapert, K., & Peugh, J. (2004). Primary care and health system performance: adults’ experiences in five countries. Health Affairs, Web Exclusive. Retrieved April 4, 2007 at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.487.

  • Stewart J.H., McCredie M.R., McDonald S.P. (2004). The incidence of treated end-stage renal disease in New Zealand Mäori and Pacific Island people and Indigenous Australians Nephrology Dialysis Transplantation 19(3):678–685

    Google Scholar 

  • UK Renal Registry (2003). Sixth Annual UK Renal Registry Report 2003. UK Renal Registry, Bristol, UK.

  • USRDS (2002, 2003, and 2004). Annual data report: Atlas of end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

  • Vonesh E.F., Moran J. (1999). Mortality in end-stage renal disease: A reassessment of differences between patients treated with hemodialysis and peritoneal dialysis. Journal of the American Society of Nephrology 10:354–365

    Google Scholar 

  • Wood J.D., Port F.K., Stannard D., Blagg C.R., Held P.J. (1996). Comparison of mortality with home hemodialysis and center hemodialysis: A national study. Kidney International 49:1464–1470

    Article  Google Scholar 

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Authors and Affiliations

  1. Health Economics, Centre for Health Services Research and Policy, School of Population Health, University of Auckland, Auckland, New Zealand

    Toni Ashton

  2. Department of Renal Medicine, Middlemore Hospital, Otahuhu, Auckland, New Zealand

    Mark Roger Marshall

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  1. Toni Ashton
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  2. Mark Roger Marshall
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Correspondence to Toni Ashton.

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Ashton, T., Marshall, M.R. The organization and financing of dialysis and kidney transplantation services in New Zealand. Int J Health Care Finance Econ 7, 233–252 (2007). https://doi.org/10.1007/s10754-007-9023-x

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