Philip A. McFarlane|Andreas Pierratos|Donald A. Redelmeier
Cost savings of home nocturnal versus conventional in-center hemodialysis
Health Sciences Centre|Sunnybrook Health Science Centre|Humber River Regional Hospital|St Michael’s Hospital|Health Sciences Centre|Sunnybrook Health Science Centre|Humber River Regional Hospital|St Michael’s Hospital|Health Sciences Centre|Sunnybrook Health Science Centre|Humber River Regional Hospital|St Michael’s Hospital
cost savings home nocturnal versus conventional incenter hemodialysisbackgroundhome nocturnal hemodialysis hnhd improve clinical biochemical factors people renal failure costeffectiveness relative conventional incenter hemodialysis ihd uncertain hypothesized hnhd would provide dialysis treatments lower total cost ihdmethodsa prospective oneyear descriptive costing study performed two centers toronto canada involving patients enrolled hnhd program n 33 matched cohort ihd program n 23 costs expressed mean weekly amount canadian year 2000 dollars projected mean annual cost pma calculated alsoresultsthe mean number treatments per week much higher hnhd 57 vs 30 p 0004 cost categories found less expensive hnhd staffing weekly 210 vs 423 p 0001 pma 10932 vs 22056 overhead support weekly 80 vs 238 p 0001 pma 4179 vs 12393 trend toward lower costs hospital admissions procedures weekly 23 vs 134 p 0355 pma 1173 vs 6997 medications 172 vs 231 p 0082 pma 8989 vs 12029 costs found expensive hnhd cost direct hemodialysis materials weekly 318 vs 126 p 0001 pma 16587 vs 6575 capital costs weekly 118 vs 17 p 0001 pma 6139 vs 871 trend toward higher cost laboratory tests weekly 33 vs 26 p 0094 pma 1744 vs 1364 physician costs 128 per week pma 6650 weekly mean total cost health care delivery 20 less hnhd 1082 vs 1322 p 0006 projected mean annual costs 10000 lower 56394 vs 68935conclusionshnhd provides three times many treatment hours nearly onefifth lower cost savings evident even program fundingspecific costs considered cost savings home nocturnal versus conventional incenter hemodialysis home nocturnal hemodialysis hnhd improve clinical biochemical factors people renal failure costeffectiveness relative conventional incenter hemodialysis ihd uncertain hypothesized hnhd would provide dialysis treatments lower total cost ihd prospective oneyear descriptive costing study performed two centers toronto canada involving patients enrolled hnhd program n 33 matched cohort ihd program n 23 costs expressed mean weekly amount canadian year 2000 dollars projected mean annual cost pma calculated also mean number treatments per week much higher hnhd 57 vs 30 p 0004 cost categories found less expensive hnhd staffing weekly 210 vs 423 p 0001 pma 10932 vs 22056 overhead support weekly 80 vs 238 p 0001 pma 4179 vs 12393 trend toward lower costs hospital admissions procedures weekly 23 vs 134 p 0355 pma 1173 vs 6997 medications 172 vs 231 p 0082 pma 8989 vs 12029 costs found expensive hnhd cost direct hemodialysis materials weekly 318 vs 126 p 0001 pma 16587 vs 6575 capital costs weekly 118 vs 17 p 0001 pma 6139 vs 871 trend toward higher cost laboratory tests weekly 33 vs 26 p 0094 pma 1744 vs 1364 physician costs 128 per week pma 6650 weekly mean total cost health care delivery 20 less hnhd 1082 vs 1322 p 0006 projected mean annual costs 10000 lower 56394 vs 68935 hnhd provides three times many treatment hours nearly onefifth lower cost savings evident even program fundingspecific costs considered