title: Cost calculations during "dire straits": a cost-of-illness analysis of regular hemodialysis for end-stage renal disease in Greece.
abstract: OBJECTIVE
  More than 3 million people worldwide suffer from end-stage renal disease (ESRD). Even though regular hemodialysis is considered very costly, it is still the most commonly used method of treatment in Greece. The aim of this study is to provide a current estimate of the annual patient cost for ESRD-related regular hemodialysis, especially during a period of economic instability for Greece.
  
  
  METHODS
  Data was collected from 113 anonymous patient files from 3 dialysis units. The cost analysis includes the following parameters: hospitalization, disposable supplies, medication, meals, contaminants, human resources and equipment depreciation/utilization.
  
  
  RESULTS
  The cost of a regular hemodialysis session was estimated at €177.12. Human resources account for 43.53% of the hemodialysis cost, while expendable supplies and medication account for 24.79% and 21.16%, respectively. The total annual cost of ESRD per patient was calculated at €34,012.31, which breaks down into €27,630.72 (81.24%) for hemodialysis, €4,800.64 (14.11%) for hospitalization, €1,454.84 (4.28%) for laboratory tests and €126.11 (0.37%) for microsurgery.
  
  
  CONCLUSIONS
  ESRD entails a significant economic burden for the Greek health care system. In a current context of ongoing austerity measures, which severely pressure the health care budget, further research should be performed in order to identify possible ways to reduce costs and improve management of the disease.
authors.affiliation: Department of Health Economics, National School of Public Health, Athens - Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Naoum
authors.affiliation: Agios Panteleimon General Hospital of Nikea-Piraeus, Athens - Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Topkaroglou
authors.affiliation: Department of Accommodation Facilities For Hosting Asylum Applicants or Third Country Nationals Belonging to Vulnerable Groups, First Reception Service, Ministry of the Interior, Athens - Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kitsonis
authors.affiliation: Department of Health Economics, National School of Public Health, Athens - Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Skroumpelos
authors.affiliation: Department of Health Economics, National School of Public Health, Athens - Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Athanasakis
authors.affiliation: Center for Nephrology, G. Papadakis, Nikea Hospital, Athens - Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Iatrou
authors.affiliation: Nephrology Department and Renal Transplantation Unit, Laiko Hospital, Athens - Greece.
authors.forename: John
authors.initials: J
authors.lastname: Boletis
authors.affiliation: Department of Health Economics, National School of Public Health, Athens - Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kyriopoulos
mesh_terms: D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006435:Renal Dialysis / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies