title: A cost analysis of kidney replacement therapy options in Palestine.
abstract: This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD) and home hemodialysis (HD), are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16,277 for the first year; the estimated cost of HD per patient averaged US$16,085 per year--nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life.
authors.affiliation: Jackson State University, MS, USA younis99@gmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Younis
authors.affiliation: Ministry of Health, Ramallah, Palestine.
authors.forename: Samer
authors.initials: S
authors.lastname: Jabr
authors.affiliation: Al-watani Hospital, Ramallah, Palestine.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Al-Khatib
authors.affiliation: University of Texas at San Antonio, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Forgione
authors.affiliation: Friedrich Schiller University of Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hartmann
authors.affiliation: Zirve University, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kisa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D006302:Health Services Research; D006801:Humans; D007674:Kidney Diseases / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics*; D012307:Risk Factors
keywords: Palestine Ministry of Health; average cost; costs; hemodialysis; kidney transplant; resource allocation