Elsevier

Kidney International

Volume 81, Issue 3, 1 February 2012, Pages 307-313
Kidney International

Original Article
An economic assessment model for in-center, conventional home, and more frequent home hemodialysis

https://doi.org/10.1038/ki.2011.338Get rights and content
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More intensive and/or frequent hemodialysis may provide clinical benefits to patients with end-stage renal disease; however, these dialysis treatments are more convenient to the patients if provided in their homes. Here we created a standardized model, based on a systematic review of available costing literature, to determine the economic viability of providing hemodialysis in the home that arrays costs and common approaches for assessing direct medical and nonmedical costs. Our model was based on data from Australia, Canada, and the United Kingdom. The first year start-up costs for all hemodialysis modalities were higher than in subsequent years with modeled costs for conventional home hemodialysis lower than in-center hemodialysis in subsequent years. Modeled costs for frequent home hemodialysis was higher than both in-center and conventional home hemodialysis in the United Kingdom, but lower than in-center hemodialysis and higher than conventional home hemodialysis in Australia and Canada in subsequent years. The higher costs of frequent compared to conventional home hemodialysis were because of higher consumable usage due to dialysis frequency. Thus, our findings reinforce the conclusions of previous studies showing that home-based conventional and more frequent hemodialysis may provide clinical benefit at reasonable costs.

KEYWORDS

conventional in-center hemodialysis
costing study
end-stage renal disease
home hemodialysis
modeling
nocturnal home hemodialysis

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All the authors declared no competing interests.

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