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Health economic evaluation: cost analysis of dialysis treatments for patients with end stage renal disease in the Northern Territory

You, Jiqiong (2000). Health economic evaluation: cost analysis of dialysis treatments for patients with end stage renal disease in the Northern Territory. Master Thesis, Northern Territory University.

Document type: Thesis
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Author You, Jiqiong
Title Health economic evaluation: cost analysis of dialysis treatments for patients with end stage renal disease in the Northern Territory
Institution Northern Territory University
Publication Date 2000
Thesis Type Master
Subjects 1199 - Other Medical and Health Sciences
1499 - Other Economics
Abstract Costs for treating End Stage Renal Disease (ESRD) patients were estimated for the financial years 1996/97 and 1997/98, using a hospital costing model. A total of 165 patients were treated: 101Aboriginal and 64 non-Aboriginal, at a total cost of $12.4m in this two-year period. These 165 patients, around 0.7% of total inpatients, used up 31.6% of 59,568 episodes (18,527) and 8.8% of total inpatient $140 millions ($12.4 m) in the Top End Hospitals of the NT in the study period. Among $1:2.4m, $9.5m (75%) was used in routine haemodialysis treatment (RHI) and $2.9m (25%) in hospitalisation.

Whole year RHT per patient in the study was cos ted at approximately $82,000 in 1996/97 and $88,000 in 1997/98. The combined average cost per RHT in two years was $524, or $78,600 per patient completing a year's treatment. Hospitalisations for comorbidities occurred in 86% of Aboriginal and 39% of non-Aboriginal patients. For non-Aboriginals, the average cost per patient was $8,229 (with 1.2 admissions and 13 length of stay). For Aboriginals, it was $23,140 (with 4.1 admissions and 35 days). All these statistics were significantly higher in Aboriginals than in non-Aboriginals (p <0.05). After adjusted for patient year, there was still statistical significant between two groups, which was $41,648 for Aboriginals vs. $21,295 for non-Aboriginals (p<0.05). Aboriginals tended to be commonly admitted for fluid overload, respiratory diseases and dialysis complications, while non-Aboriginals were admitted for dialysis-related complications, access procedures and cardiovascular disease. But from cost concerns, septicaemia, dialysis-related complications, respiratory diseases and skin diseases were strongly related to the overall costs in the Aboriginal patients. In the non-Aboriginals, cardiovascular disease, fluid, electrolyte and acid disorders and digestive diseases were highly related to the overall costs.


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