國家衛生研究院 NHRI:Item 3990099045/8479
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    题名: Trends of cost and mortality of patients on haemodialysis with end stage renal disease
    作者: Chang, YK;Hsu, CC;Chen, PC;Chen, YS;Hwang, SJ;Li, TC;Huang, CC;Li, CY;Sung, FC
    贡献者: Division of Health Services and Preventive Medicine
    摘要: AIM: The prevalence of end-stage renal disease in Taiwan is amongst the highest in the world. Treatment reimbursement for hemodialysis was capped in 1996 in order to contain costs. This study evaluated temporal changes in the costs and utilization of medical care and mortality in patients receiving haemodialysis following capped reimbursement. METHODS: Using insurance claims data in Taiwan between 1998 to 2009, we established 8 annual subcohorts of patients with incident haemodialysis, increasing from 6,099 in 1998 to 7,745 in 2005. With a 4-year follow-up paradigm for each subcohort, we evaluated resources use and costs of medical services, as well as mortality trends. RESULTS: The annual mean cost for each haemodialysis patient increased from US $431 to $737 for emergency visits, US $9,007 to $13,280 for hospitalizations and US $79,141 to $92,416 (16.8% increase) for total costs, from the initial to final subcohorts, respectively. Compared to the 1998 subcohort, the adjusted hazard ratio of deaths declined from 0.97 (95% CI 0.91 to 1.02) for the 1999 subcohort to 0.86 (95% CI 0.82 to 0.91) for the 2005 subcohort (p for trend <0.001). The corresponding cumulative probability of deaths decreased from 45.5% to 35.4%. CONCLUSIONS: The mortality for patients with haemodialysis decreased annually, whereas the overall annual cost increased despite capped reimbursement for hemodialysis. These results encourage further study on reasons of increased uses of emergency service and hospitalization.
    日期: 2014-12-16
    關聯: Nephrology. 2015 Apr ;20(4):243-249.
    Link to: http://dx.doi.org/10.1111/nep.12380
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1320-5358&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000352100800004
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84925459924
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