Cost-effectiveness of vascular access for haemodialysis: arteriovenous fistulas versus arteriovenous grafts.
Eur J Vasc Endovasc Surg
; 45(1): 84-92, 2013 Jan.
Article
en En
| MEDLINE
| ID: mdl-23153926
ABSTRACT
BACKGROUND:
The use of an arteriovenous fistula (AVF) for haemodialysis treatment may be associated with a high early failure rate, but usually good long-term patency, while using an arteriovenous graft (AVG) yields a lower early failure rate with worse long-term patency. The aim of this study was to calculate and compare the costs and outcome of AVF and AVG surgery in terms of early and long-term patencies.METHODS:
A decision tree and a Markov model were constructed to calculate costs and performance of AVFs and AVGs. The model was populated with a retrospective cohort of HD patients receiving their first VA. The outcomes were determined probabilistically with a 5-year follow-up.RESULTS:
AVFs were usable for a mean (95% CI) of 28.5 months (24.6-32.5 months), while AVGs showed a patency of 25.5 months (20.0-31.2 months). The use of AVFs was the dominant type of VA and 631 could be saved per patient/per month patency compared to AVG use. Regardless of the willingness to pay, the use of AVFs yielded a higher probability of being cost-effective compared to AVGs.CONCLUSIONS:
AVFs are more cost-effective than AVGs. Nonetheless, early failure rates significantly influence AVF performance and initiatives to reduce early failure can improve its cost-effectiveness.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Derivación Arteriovenosa Quirúrgica
/
Diálisis Renal
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Costos de la Atención en Salud
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Implantación de Prótesis Vascular
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Fallo Renal Crónico
Tipo de estudio:
Etiology_studies
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Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2013
Tipo del documento:
Article