Universität zu Köln

Shukri, Arim, Mettang, Thomas, Scheckel, Benjamin, Schellartz, Isabell, Simic, Dusan, Scholten, Nadine, Mueller, Martin and Stock, Stephanie ORCID: 0000-0002-1726-9300 (2022). Hemodialysis and Peritoneal Dialysis in Germany from a Health Economic View-A Propensity Score Matched Analysis. Int. J. Environ. Res. Public Health, 19 (21). BASEL: MDPI. ISSN 1660-4601

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Abstract

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are deemed medically equivalent for therapy of end-stage renal disease (ESRD) and reimbursed by the German statutory health insurance (SHI). However, although the home dialysis modality PD is associated with higher patient autonomy than HD, for unknown reasons, PD uptake is low in Germany. Hence, we compared HD with PD regarding health economic outcomes, particularly costs, as potentially relevant factors for the predominance of HD. Methods: Claims data from two German health insurance funds were analysed in a retrospective cohort study regarding the prevalence of HD and PD in 2013-2016. Propensity score matching created comparable HD and PD groups (n = 436 each). Direct annual health care costs were compared. A sensitivity analysis included a comparison of different matching techniques and consideration of transportation costs. Additionally, hospitalisation and survival were investigated using Poisson regression and Kaplan-Meier curves. Results: Total direct annual average costs were higher for HD (euro47,501) than for PD (euro46,235), but not significantly (p = 0.557). The additional consideration of transportation costs revealed an annual cost advantage of euro7000 for PD. HD and PD differed non-significantly in terms of hospitalisation and survival rates (p = 0.610/p = 0.207). Conclusions: PD has a slight non-significant cost advantage over HD, especially when considering transportation costs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Shukri, Arim UNSPECIFIED UNSPECIFIED UNSPECIFIED Mettang, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheckel, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schellartz, Isabell UNSPECIFIED UNSPECIFIED UNSPECIFIED Simic, Dusan UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholten, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Stock, Stephanie UNSPECIFIED orcid.org/0000-0002-1726-9300 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-676656
DOI:	10.3390/ijerph192114007
Journal or Publication Title:	Int. J. Environ. Res. Public Health
Volume:	19
Number:	21
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	1660-4601
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; MORTALITY; SURVIVAL; RATES; COST Multiple languages Environmental Sciences; Public, Environmental & Occupational Health Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67665