Incremental cost-effectiveness analysis of a multidisciplinary renal education program for patients with chronic renal disease.
OBJECTIVE
The aim of this economic evaluation is to address the economic impact of a multidisciplinary renal patient education on the work maintenance of patients with chronic renal disease.


METHODS
A total of 281 patients were recruited. An incremental cost-effectiveness analysis considering direct medical costs and days in the work force was performed. In addition, a Cox proportional hazards survival analysis was performed to investigate the effect of receiving the intervention on early retirement due to work disability.


RESULTS
The incremental cost-effectiveness ratio [95% CI] per day in the work force saved was 737.02 degrees euro [-3345.64; 3093.03] in the whole group, 73.74 degrees euro [-995.28; 1429.92] in patients with a mild limitation and -113.25 degrees euro [-3252.06; 1525.58] in patients with a moderate to severe limitation in kidney function. After adjusting for observed time period, serum creatinine and age, having received the intervention had an almost significant medium-term protective effect on early retirement (hazard ratio 0.314, 95% CI 0.10-1.03, p = 0.0557).


CONCLUSIONS
The cost-effectiveness of the multidisciplinary patient education highly depends on the level of limitation in kidney function and the intervention may be cost-effective in maintaining patients with mild limitation in kidney function in the work force.
Sabariego
Carla
C
Department of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University of Munich, Munich, Germany.
Grill
Eva
E
Brach
Mirjam
M
Fritschka
Emanuel
E
Mahlmeister
Jarmila
J
Stucki
Gerold
G
D000328:Adult; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000191:economics*; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000191:economics* / Q000534:rehabilitation; D012179:Retirement