chronic kidney disease. clinical epidemiology - 1 - Oxford University ...

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Regional Health Authority, Milan, Italy, 3S. Uboldo Hospital ... increasing co-morbidities; few European studies investigated healthcare costs related to.
Nephrology Dialysis Transplantation 30 (Supplement 3): iii174–iii194, 2015 doi:10.1093/ndt/gfv175.21

CHRONIC KIDNEY DISEASE. CLINICAL EPIDEMIOLOGY - 1 FP339

ECONOMIC BURDEN OF THE PROGRESSION OF CHRONIC KIDNEY DISEASE ESTIMATED THROUGH ADMINISTRATIVE DATABASE ANALYSIS

Alessandro Roggeri1, Daniela P Roggeri1, Carlo Zocchetti2 and Ferruccio Conte3on behalf of ReNe (Lombardy Nephrological Network) 1 ProCure Solutions, Health Economics, Nembro (BG), Italy, 2Lombardy Region, Regional Health Authority, Milan, Italy, 3S. Uboldo Hospital, Nephrology Unit, Cernusco sul Naviglio, Italy Introduction and Aims: Chronic kidney disease (CKD) worsening is associated to increasing co-morbidities; few European studies investigated healthcare costs related to the progression of the pathology and the economic impact of dialysis entrance. Aim of the present study was to evaluate direct healthcare costs in charge to the Lombardy Regional Health Service (RHS) in patients with CKD in the first 12 months after starting haemodialysis and in the 24 months before it. Methods: All subjects resident in Lombardy Region (Italy) recorded in the administrative databases with the first dialysis in the period January 1, 2011December 31, 2011 were selected and observed for the first 12 months after dialysis entrance and for the 24 months before it. Direct healthcare costs in charge to RHS were estimated (drugs, hospitalizations, diagnostic/therapeutic procedures and outpatient episodes of care). Considering the aim of this analysis, patients with acute

kidney injury, died and who stopped dialysis during the follow-up were excluded from this analysis. As data originated from Lombardy regional databases, the perspective of the present analysis was that of RHS and the study was retrospective and observational. Results: Over a population of more than 9,700,000 inhabitants, 1,067 patients starting dialysis were selected (average age 65.2, 34.3% females). Of them 82% received only haemodialysis (HD), 13% only peritoneal dialysis (PD) and 5% both treatments. Total yearly cost per patient was 5,239€ in the period -24/-12 months before dialysis, 12,303€ in the period -12/0 months before dialysis and 38,821€ (40,132€ for HD patients and 30,444€ for PD patients) in the first year of dialysis. The composition of healthcare costs is reported in table 1. Conclusions: Direct Healthcare costs associated to the treatment of patients with CKD increased dramatically with the progression of the disease and particularly after starting dialysis treatment highlighting the importance of prevention programs and early diagnosis. The present analysis revealed also that administrative databases analysis could be helpful in decision making for healthcare resource allocation. FP339 Table 1: healthcare cost composition ( per patient/year)

Drugs Hospitalizations Diagnostic/therapeutic procedures and outpatient episodes of care HD/PD Total

© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

-24/-12 months pre dialysis

-12/0 months pre dialysis

0/12 months after dialysis

2,040€ 2,473€ 726€

2,555€ 8,760€ 988€

2,544€ 6,880€ 3,799€

0€ 5,239€

0€ 12,303€

25,598€ 38,821€