Impacts of age, diabetes, gender, and access type on costs associated with vascular access among Chinese patients on hemodialysis.
Int J Artif Organs
; 44(5): 302-309, 2021 May.
Article
en En
| MEDLINE
| ID: mdl-33016167
ABSTRACT
OBJECTIVES:
Examine the impacts of age, diabetes, gender, and access type on vascular access (VA) associated costs among Chinese hemodialysis (HD) patients.METHODS:
We retrospectively included patients whose first permanent VA was created at the West China Hospital. Clinical characteristics, maturation, intervention, utilization, and exchange of every VA, as well as VA-related infection were collected. The study period for each patient was from HD initiation to the last follow-up. VA-related costs, including those for placement and intervention procedures, were calculated according to the standards set in 2019 for Chinese tertiary hospitals. Mann-Whitney U and Chi-square tests were conducted for comparisons between groups.RESULTS:
A total of 358 Chinese HD patients experienced functionally 143 arteriovenous fistula (AVF), 22 arteriovenous graft (AVG), and 439 tunneled cuffed central venous catheter (tcCVC) during a median study period of 26 (IQR 13-44) months, of which 42.5% used more than one permanent VA. The median annual VA-related cost in the groups of age >75 years and ⩽75 years, diabetes and non-diabetes, male and female, was $525 and $397 (p = 0.016), $459 and $462 (p = 0.64), $476 and $445 (p = 0.94), respectively. The median monthly costs for AVF ($18), AVG ($289), and tcCVC ($37) were significantly different.CONCLUSION:
HD patients aged >75 years had significantly higher annual VA-related costs. However, the annual VA-related costs did not differ across the diabetes groups or the gender groups. AVF was the most cost-effective permanent VA type in China, partly due to the inexpensive materials used compared to AVG or tcCVC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Derivación Arteriovenosa Quirúrgica
/
Diálisis Renal
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Costos de la Atención en Salud
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Catéteres Venosos Centrales
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Fallo Renal Crónico
Tipo de estudio:
Guideline
/
Health_economic_evaluation
/
Observational_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Aged
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Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int J Artif Organs
Año:
2021
Tipo del documento:
Article
País de afiliación:
China