Original Investigations: Dialysis TherapiesCost analysis of ongoing care of patients with end-stage renal disease: The impact of dialysis modality and dialysis access*,**,★,★★
Section snippets
Setting
The Conjoint Medical and Research Ethics Board at the University of Calgary (Alberta, Canada) approved the study protocol. In July 1999, a total of 416 patients were treated locally with dialysis (266 patients, in-center hemodialysis; 55 patients, satellite hemodialysis; 79 patients, peritoneal dialysis; 13 patients, home hemodialysis; and 3 patients, self-care hemodialysis). Three hundred thirty-two of these patients had been on dialysis therapy longer than 6 months and were eligible for
Patients
Of 332 patients eligible for the study, 166 patients were enrolled; 88 patients were treated with in-center hemodialysis; 31 patients, satellite hemodialysis; 9 patients, home/self-care hemodialysis; and 38 patients, peritoneal dialysis (32 patients, CAPD; 6 patients, CCPD). One hundred ten patients were not enrolled because of inability to speak English or inability to contact them after repeated attempts, and 56 patients who were contacted did not wish to participate. Nonenrolled patients
Discussion
Direct health care costs for patients with ESRD varied substantially among patients treated with different dialysis modalities. In-center hemodialysis was the most expensive renal replacement therapy, costing more than $50,000/patient-year. Self-care dialysis (ie, home/self-care hemodialysis and peritoneal dialysis) costs an average $20,000 less compared with in-center hemodialysis, in large part because of a lower requirement for nursing care for outpatient dialysis.
Our results, based on
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Work performed at Foothills Medical Centre, Calgary, Alberta, Canada.
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Supported in part by The Alberta Heritage Foundation for Medical Research and The Center for Advancement of Health, Calgary Regional Health Authority, Calgary, Alberta, Canada.
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Address reprint requests to Braden Manns, MD, Foothills Medical Centre, 1403 29th St NW, Calgary, Alberta, Canada, T2N 2T9. E-mail: [email protected]
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