Journal
KIDNEY INTERNATIONAL
Volume 81, Issue 3, Pages 307-313Publisher
ELSEVIER SCIENCE INC
DOI: 10.1038/ki.2011.338
Keywords
conventional in-center hemodialysis; costing study; end-stage renal disease; home hemodialysis; modeling; nocturnal home hemodialysis
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Funding
- Baxter Healthcare Corporation, McGaw Park, IL
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More intensive and/or frequent hemodialysis may provide clinical benefits to patients with end-stage renal disease; however, these dialysis treatments are more convenient to the patients if provided in their homes. Here we created a standardized model, based on a systematic review of available costing literature, to determine the economic viability of providing hemodialysis in the home that arrays costs and common approaches for assessing direct medical and nonmedical costs. Our model was based on data from Australia, Canada, and the United Kingdom. The first year start-up costs for all hemodialysis modalities were higher than in subsequent years with modeled costs for conventional home hemodialysis lower than in-center hemodialysis in subsequent years. Modeled costs for frequent home hemodialysis was higher than both in-center and conventional home hemodialysis in the United Kingdom, but lower than in-center hemodialysis and higher than conventional home hemodialysis in Australia and Canada in subsequent years. The higher costs of frequent compared to conventional home hemodialysis were because of higher consumable usage due to dialysis frequency. Thus, our findings reinforce the conclusions of previous studies showing that home-based conventional and more frequent hemodialysis may provide clinical benefit at reasonable costs. Kidney International (2012) 81, 307-313; doi: 10.1038/ki.2011.338; published online 12 October 2011
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