4.4 Article

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

Journal

BMC HEALTH SERVICES RESEARCH
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12913-021-06566-2

Keywords

Chronic kidney disease; Cost; DAPA-CKD; Healthcare; Hospitalization; Medication

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Between 2015 and 2019, the costs of patients with chronic kidney disease (CKD) in Spain were high, with cardiovascular hospitalizations being the key determinant. Medication costs accounted for only a small proportion of total CKD costs. Costs associated with cardiovascular hospitalizations, cardiovascular and diabetic medications, as well as hospitalization and mortality rates, all decreased over the study period.
Background Data about the impact of chronic kidney disease (CKD) on health care costs in Spain are scarce This study was aimed to evaluate cumulative costs and healthcare utilisation in CKD in Spain. Methods Observational, retrospective, population-based study, which included adults who received care for CKD between 2015 and 2019. Healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until 2019. Results We identified 44,214 patients with CKD (year 2015: age 76.4 +/- 14.3 years, 49.0% women, albumin-to-creatinine ratio 362.9 +/- 176.8 mg/g, estimated glomerular filtration rate 48.7 +/- 13.2 mL/min/1.73 m(2)). During the 2015-2019 period, cumulative CKD associated costs reached 14,728.4 Euros, being cardiovascular disease hospitalizations, particularly due to heart failure and CKD, responsible for 77.1% of costs. Total medication cost accounted for 6.6% of the total cost. There was a progressive decrease in cardiovascular disease hospital costs per year (from 2741.1 Euros in 2015 to 1.971.7 Euros in 2019). This also occurred with cardiovascular and diabetic medication costs, as well as with the proportion of hospitalizations and mortality. Costs and healthcare resources use were higher in the DAPA-CKD like population, but also decreased over time. Conclusions Between 2015 and 2019, costs of patients with CKD in Spain were high, with cardiovascular hospitalizations as the key determinant. Medication costs were responsible for only a small proportion of total CKD costs. Improving CKD management, particularly with the use of cardiovascular and renal protective medications may be helpful to reduce CKD burden.

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