TY - JOUR
T1 - Out-of-pocket costs and productivity losses in haemodialysis and peritoneal dialysis from a patient interview survey in Taiwan
AU - Tang, Chao Hsiun
AU - Chen, Hsi Hsien
AU - Wu, Ming Ju
AU - Hsu, Bang Gee
AU - Tsai, Jer Chia
AU - Kuo, Chi Cheng
AU - Lin, Shih Pi
AU - Chen, Tso Hsiao
AU - Sue, Yuh Mou
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.
AB - Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.
KW - cost
KW - haemodialysis
KW - out-of-pocket cost
KW - peritoneal dialysis
KW - productivity loss
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U2 - 10.1136/bmjopen-2018-023062
DO - 10.1136/bmjopen-2018-023062
M3 - Article
C2 - 30904836
AN - SCOPUS:85063353867
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e023062
ER -