MO519THE COST OF CHRONIC KIDNEY DISEASE BEFORE RENAL REPLACEMENT THERAPY IN MOROCCO: A COST OF ILLNESS STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Amina Chrifi Alaoui ◽  
Mohammed Omari ◽  
Noura Qarmiche ◽  
Omar Kouiri ◽  
Basmat Amal Chouhani ◽  
...  

Abstract Background and Aims Chronic kidney disease (CKD) is a leading public health problem in Morocco, its consequences and costs have implications for public health policy. The present study aimed to estimate the social cost of CKD before the start of renal replacement therapy in a Moroccan region. Method A cross-sectional cost of illness study, using bottom-up approach was performed at the department of nephrology in university hospital of Fez during 2020, among stages 3 to 5 CKD patients, followed up for at least one-year. The analyzed costs include the following annual expenditures: hospitalizations, outpatient visits, day care hospital, drugs, laboratory tests, imaging, and medical specialized acts. Non-medical costs such as transportation and indirect costs like loss of productivity were also assessed. Determinants of CKD cost were identified by univariate analysis using t test, ANOVA or non-parametric tests, p < 0.05 is the level of statistical significance. Results Eighty-eight patients were included (63.6% women, mean age: 61.8±14.0 years), 76.1% were on CKD stage 4 or 5. The estimated annual social cost of CKD was 2231,12 US$ (95% CI, 1676,09-2793,93 US$). The direct cost accounted for 99,5% (direct medical cost: 91,2%, direct non-medical cost: 8,3%), and the indirect cost accounted for 0,5 % of the social cost. Hospitalizations, diagnosis and treatments represented the main expenses of the direct medical cost (32,2%, 29,7%, 32,2% respectively). The social cost components were not significantly different between CKD stages. Conclusion The cost of CKD in its early stages still lower than the cost of renal replacement therapy, which brings the light on the necessity of secondary prevention of CKD to postpone or prevent the progression toward ESRD.

2021 ◽  
Vol 1 (7) ◽  
Author(s):  
Jonathan Harris ◽  
Charlene Argáez

Strategies to contain the cost of chronic kidney disease (CKD) care and to improve patient outcomes were found across the continuum of care, from prevention and early disease management through later-stage interventions such as conservative management, dialysis, and transplantation. A variety of health system strategies, including funding reform, were identified to help support and enable sustainable CKD care. For those at risk of CKD or in early stages of the disease, public health interventions to support healthy behaviours and ensure access to primary health care seem crucial to preventing or delaying disease progression. For later-stage patients requiring renal replacement therapy, enhancing access to transplantation and home-based dialysis has the potential to reduce costs while improving outcomes and quality of life. Conservative management without dialysis is an option for those who may not be good candidates for renal replacement therapy or who wish to choose a less-invasive care option. From a health system policy perspective, funding reform may be warranted to enhance team-based CKD care with good continuity. Policy-makers should also consider the ways in which improving financial supports for caregivers, providing travel and expense reimbursement for home dialysis patients and living organ donors, and providing support for utility and ancillary costs of home dialysis could incentivize sustainable CKD care.


Nefrología ◽  
2021 ◽  
Author(s):  
Luis Alberto Dorantes-Carrillo ◽  
Martha Medina-Escobedo ◽  
Yaseth Aridai Cobá-Canto ◽  
Alberto Alvarez-Baeza ◽  
Nina Méndez Domínguez

PLoS ONE ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. e0233976 ◽  
Author(s):  
Erik Dovgan ◽  
Anton Gradišek ◽  
Mitja Luštrek ◽  
Mohy Uddin ◽  
Aldilas Achmad Nursetyo ◽  
...  

2013 ◽  
Vol 1 (2) ◽  
pp. 72-74 ◽  
Author(s):  
Joerg Latus ◽  
Elisabeth Höring ◽  
Matthias Voehringer ◽  
Dieter Ratge ◽  
M. Dominik Alscher ◽  
...  

2019 ◽  
Vol 11 (1) ◽  
pp. 73 ◽  
Author(s):  
Silvia Coretti ◽  
Filippo Rumi ◽  
Americo Cicchetti

Major depression (MD) is a major cause of disability and a significant public health problem due to strong physical and mental impairment, possible complications for patients (including suicides), serious social and working problems to the patient and his/her family. We provide an overview of the social cost of Major depression worldwide. We conducted a systematic literature review. Two search engines were queried. Screening of records and summary of evidence was performed by two researchers blindly. The review was conducted in accordance with the standards of the PRISMA guidelines. Twenty studies met the inclusion criteria. Despite the heterogeneity in terms of population, setting and estimation techniques, the studies showed that the largest share of the burden of disease is represented by indirect costs. Among direct healthcare costs, inpatient care represents the most significant item, followed by outpatient care. The average total direct cost of depression ranges between €508 and €24 069, depending on the jurisdiction where the analysis was run and the range of cost items included. Indirect costs range between €1963 and €27 364. Evidence on the cost of MD in some countries is currently lacking. A deeper understanding of the drivers of the economic burden of disease is a crucial starting point for studies concerned with the cost-effectiveness of new treatment strategies.


2019 ◽  
Vol 5 (3) ◽  
pp. 148
Author(s):  
Yuli Hermansyah ◽  
Dinda Ayu Wanodya Supriatiningsih ◽  
Bagus Hermansyah

Stage 5 chronic kidney disease (CKD) is a condition where the renal function decrease, marked by the GFR value < 15/ml/minute/1,73 m2 with or without kidney damage history for 3 months or more that needs kidney replacement therapy, including hemodialysis. In Indonesia, hemodialysis was chosen for 82% from all the cases that needs kidney replacement therapy. However, the cost for hemodialysis therapy is considered as too expensive and burdens The National Health Insurance, Badan Penyelenggara Jaminan Sosial (BPJS), allowing the reuse of hemodialyzer as an alternative for cost-effectiveness. Re-use hemodialyzer is a term for using the same hemodialyzer for the same patient but on different therapy session. The main purpose of this research is to investigate the difference of Potassium level in stage 5 chronic kidney disease patients whose using new and re-use hemodialyzer in RSD dr. Soebandi Jember. This research used quasi experimental design by using blood sample that will be measured for the potassium level after using new hemodialyzer and re-use hemodialyzer for the 4th time in Hemodialysis Installation of RSD dr. Soebandi Jember on December 2018. Total sample of 19 patients chosen using inclusion and exclusion criteria. Collected data were analyzed using paired t-test. The result of statistical test shows that there is no significance potassium level difference in stage 5 chronic kidney disease whose using new and re-use hemodialyzer for the 4th time (p=0,094). The effectivity of hemodialyzer that still has a good condition and hemodialysis therapy that has been done in accordance with the procedure until the 4th reuse is the main factor of this result.   Keywords: CKD, potassium, re-use hemodialyzer


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