title: Cost-effectiveness analysis of dialysis and kidney transplant in patients with renal impairment using disability adjusted life years in Iran.
abstract: BACKGROUND
  This cross-sectional study was conducted to compare the cost-effectiveness of three therapeutic methods of long-term hemodialysis, kidney transplant from a living person and kidney transplant from a cadaver utilizing Disability Adjusted Life Years (DALY) using data from the records of patients referred to Afzalipour Hospital of Kerman in 2012.
  
  
  METHODS
  This cross-sectional study utilizing Disability Adjusted Life Years (DALY) as outcome measure, used data from the records of patients referred to Afzalipour Hospital of Kerman in 2012. The decision tree model and decision tree software (Tree Age pro 11) were used for data analysis. In this research, costs and effects were studied from the patients and healthcare providers' perspective.
  
  
  RESULTS
  In the patient's perspective, the CER of dialysis was 5.04 times greater than transplant from a living person and 6.15 times higher than transplant from a cadaveric donor. In the hospital's perspective, the average cost-effectiveness ratio of dialysis was 8.4 times greater than transplant from a living person and 14.07 times higher than transplant from a cadaver. The smaller the C-E ratio, the greater was the cost-effectiveness. In both perspectives, the order of effectiveness of treatment methods were transplant from a cadaver, transplant from a living person and dialysis.
  
  
  CONCLUSIONS
  Considering the results obtained in this study, measures should be taken to increase the desire for organ donation from brain-dead patients, living people and patients' relatives.
authors: MSc of Health Economics, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. s.yaghubi91@yahoo.com.
authors: Safiye
authors: S
authors: YaghoubiFard
authors: Assistant Professor, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. rgoudarzi@kmu.ac.ir.
authors: Reza
authors: R
authors: Goudarzi
authors: Assistant Professor, Regional Centre for Training of HIV / AIDS, Institute for Futures Studies in Health, Kerman, Iran. abbas_etminan@yahoo.com.
authors: Abbas
authors: A
authors: Etminan
authors: Associate Professor, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. rbaneshi@yahoo.com.
authors: MohammadReza
authors: M
authors: Baneshi
authors: Assistant Professor, Modeling in Health Research Center , Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. mohsenbarooni@gmail.com.
authors: Mohsen
authors: M
authors: Barouni
authors: Health Insurance Organization, Head of Kerman office, Kerman, Iran. yamahdi1386@yahoo.com.
authors: Mohammad
authors: M
authors: Jafari Sirizi
keywords: Chronic Dialysis; Cost-Effectiveness; DALY; Kidney Transplant