Resumo

LORENZO, V. et al. Economic evaluation of haemodialysis: Analysis of cost components based on patient-specific data. Nefrología (Madr.) [online]. 2010, vol.30, n.4, pp.403-412. ISSN 1989-2284.

Background: Hemodialysis (HD) cost analysis provides information about the economic impact of the disease on the community. Its knowledge is crucial to adequate and optimize health resources. Our aim was to study sanitary and non-sanitary direct costs of HD, based on patients individual data. Furthermore, the effect of sociocultural factors and comorbidity on costs was evaluated. Material and methods: Retrospective and observational study of prevalence costs produced during one year of HD therapy. All patients from North Health District of Tenerife province (Canary Islands, Spain) included for at least 3 months on HD were considered for the study. Sociodemographic parameters and comorbidity data were collected from a generic individual survey and reviewing database records. Direct sanitary and non-sanitary costs were organized in 6 categories: HD sessions, medication costs, hospitalization costs (evaluated by Diagnosis-Related Groups classification system), outpatient care (including consultation and complementary studies); sanitary material and patient transportation. Results: Finally, 161 patients were included (63 ± 16 years, 63% males, 38% diabetics). Of note, the proportions of sociocultural deprivation was high among this population (75-85% did not complete first school and had non-qualified jobs). Mean cost of global therapy was 43,070 ± 13,932 €. Proportional allocation of costs was as follow: HD sesion 51%, pharmacy 27%, hospitalization 17%, transportation 3% and ambulatory care 2%. It was no association between sociocultural profile, comorbidity and therapy cost. Conclusions: This is the first study of HD costs, itemized by components of expenses, based in individual data and introducing GRD model for hospitalization cost. The highest expenses corresponded to HD sessions and medication (79%), both very homogeneous to this patient population. The saving in economic terms should be, fundamentally, the prevention of CKD.

Palavras-chave : Hemodialysis; Costs-of-illness; End-stage renal disease; Diagnosis-related groups.

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