Economic consequences of an increased number of patients on outgoing dialysis.
OBJECTIVE
During the past 10 years the number of prevalent patients on dialysis treatment has doubled in Denmark and the number is expected to increase further. The majority of Danish patients on dialysis receive haemodialysis at a hospital-based centre, and increasing patient numbers will put pressure on these dialysis centres. In order to reduce this pressure, more patients will need to be offered dialysis as outgoing treatment. The aim of this study was to analyse the economic consequences of an increased number of patients on outgoing dialysis in a Danish setting.


METHODS
A Markov model using Danish cost estimates and clinical parameters from the Danish National Registry was developed and used to simulate changes of dialysis modalities, exits to transplantation or death as well as entry of new incident patients over a period of 10 years.


RESULTS
The development in total annual costs over a 10-year period showed that an increased number of patients on outgoing dialysis will lead to total savings of approximately €9.6 million.


CONCLUSIONS
The estimated savings of approximately €9.6 million only constitute 0.6% of the total cost of dialysis. In terms of cost over time, therefore, an increased number of patients on outgoing treatment will not lead to an increase in costs; the total cost of treatment will probably be unchanged or slightly reduced. The results were sensitive to inclusion of capital costs and exclusion of costs associated with complications or comorbidity.
Olsen
Jens
J
Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Odense, Denmark. jeo@cast.sdu.dk
Bonnevie
Birgitte
B
Palmhøj-Nielsen
Camilla
C
Povlsen
Johan V
JV
D003718:Denmark; D017048:Health Care Costs; D006436:Hemodialysis Units, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D006437:Hemodialysis, Home / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008390:Markov Chains; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D012648:Self Care / Q000191:economics* / Q000706:statistics & numerical data