title: Cost analysis of living donor kidney transplantation in China: a single-center experience.
abstract: BACKGROUND
  Kidney transplantation is the most cost-effective option for the treatment of end-stage renal disease, but the financial aspects of kidney transplantation have not yet been fully investigated. The purpose of this study was to determine the hospital cost of living donor kidney transplantation in China and to identify factors associated with the high cost.
  
  
  METHODS
  Demographic and clinical data of 103 consecutive patients who underwent living donor kidney transplantation from January 2007 to January 2011 at our center were reviewed, and detailed hospital cost of initial admission for kidney transplantation was analyzed. A stepwise multiple regression analysis was computed to determine predictors affecting the total hospital cost.
  
  
  RESULTS
  The median total hospital cost was US $10,531, of which 69.2% was for medications, 13.2% for surgical procedures, 11.4% for para clinics, 3.7% for accommodations, 0.5% for nursing care, and 2.0% for other miscellaneous medical services. A multivariate stepwise logistic regression model for overall cost of transplantation revealed that the length of hospital stay, induction therapy, steroid-resistant rejection, maintenance therapy, infection status and body weight were independent predictors affecting the total hospitalization cost.
  
  
  CONCLUSIONS
  Although the cost of living donor kidney transplantation in China is much lower than that in developed countries, it is a heavy burden for both the government and the patients. As medications formed the greater proportion of the total hospitalization cost, efforts to reduce the cost of drugs should be addressed.
authors: Organ Transplantation Institute of PLA, Changzheng Hospital, Second Military Medical University, Shanghai, PR China.
authors: Wenyu
authors: W
authors: Zhao
authors: Lei
authors: L
authors: Zhang
authors: Shu
authors: S
authors: Han
authors: Youhua
authors: Y
authors: Zhu
authors: Liming
authors: L
authors: Wang
authors: Meisheng
authors: M
authors: Zhou
authors: Li
authors: L
authors: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003365:Costs and Cost Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000601:surgery; D016030:Kidney Transplantation / Q000191:economics* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome