title: Multicentre study of haemodialysis costs.
abstract: BACKGROUND
  Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitations: they are outdated or used indirect methods. There is also a lack of analysis performed simultaneously on Public centres (PC), with direct HD services, and partially state-subsidised centres (SC). This is an important issue since the two systems coexist in Spain.
  
  
  OBJECTIVE
  To estimate the cost of HD replacement therapy for chronic renal failure in several centres.
  
  
  METHODS
  This is a prospective and publicly-funded study, which estimates the costs for 2008 using a cost accounting system with specific allocation criteria. We collected demographic and comorbidity data for each centre.
  
  
  RESULTS
  Six centres participated, two PC and four SC. There were no significant differences between centres in terms of patient demographics, time on haemodialysis and the Charlson comorbidity index. The total cost per patient per year ranged between € 46, 254 and € 33,130. The cost per patient per year (excluding vascular access and hospital admission) for PC was € 42, 547 and € 39, 289 and for SC € 32 872, € 29, 786, € 35, 461 and € 35, 294 (23% more in PC than SC). Costs related to staff/patient/year and consumables/patient/year were 67% and 83% respectively, higher for PC than SC. The highest percentage cost was for staff (average 30.9%), which showed significant variability between centres, both in absolute numbers (staff cost per patient per year between € 18,151 and € 8504) and as a percentage (between 42.6 % and 25.4%).
  
  
  CONCLUSIONS
  Cost variability exists among different HD centres, and this can be attributed primarily to staff and consumables costs, which is higher for PC than SC.
authors.affiliation: Nephrology Department. Reina Sofía University Hospital. Tudela, Navarra, Spain. eparramo@cfnavarra.es
authors.forename: E
authors.initials: E
authors.lastname: Parra Moncasi
authors.forename: M D
authors.initials: MD
authors.lastname: Arenas Jiménez
authors.forename: M
authors.initials: M
authors.lastname: Alonso
authors.forename: M F
authors.initials: MF
authors.lastname: Martínez
authors.forename: A
authors.initials: A
authors.lastname: Gámen Pardo
authors.forename: P
authors.initials: P
authors.lastname: Rebollo
authors.forename: T
authors.initials: T
authors.lastname: Ortega Montoliú
authors.forename: T
authors.initials: T
authors.lastname: Martínez Terrer
authors.forename: F
authors.initials: F
authors.lastname: Alvarez-Ude
mesh_terms: D000368:Aged; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000191:economics*