ECONOMIC ANALYSIS OF REGULAR HEMODIALYSIS TREATMENT IN END-STAGE KIDNEY DISEASE

M RAMA PUTRA1, G RAKA WIDIANA1
1Division of Nephrology and Hypertension Department of Internal Medicine School of Medicine Udayana University/Sanglah Central Public Hospital Denpasar Bali, Denpasar, Indonesia

Background: Hemodialysis (HD) treatment is a high volume, high cost, and high risk of medical services. Most of HD treatment in Indonesia and it is universally covered by National Health Insurance.
Methods: This economic analysis is aimed to calculate HD costs and its components, and  outcomes.
Results:We conducted economic analysis of hemodialysis (HD) treatment among ESRD at Sanglah Hospital Denpasar Bali. We calculated direct, indirect and intangible cost during 5 years in 30 HD patients which were randomly selected from medical records. We found  mean total direct cost 437,093,800 IDR  (31,452.39 USD) including   double lumen catheter insertion 4,180,526 IDR  (300.82 USD); AV-fistula 5,537,683 IDR  (398.48 USD); HD treatment  351,00.000 IDR  (25,257.25 USD); medicines 59,852,000 IDR  (4,306.82 USD), including EPO, intravenous iron and oral medicines; lab tests and radiology examination 15,665,000 IDR  (1,127.22USD); mean indirect cost 41,981,333  IDR (300,20.89 USD),consists of transportation expenses and meals; mean intangible cost (loss of job opportunities) 44,546,666 IDR  (3,205.49 USD) calculated from patient’s salary or provincial minimum wages, leading to total cost 522,763,210 IDR (37,616.98 USD) for 5 years of HD treatment. We also found that among 223 patients mean KDQOL was 56.75 ±21.00. During one  years of followed up, among 222 patients evaluated, 18 patients died, leading to 91.9 % of one year survival, with mean survival time 358 days (95%CI: 354 -362 days).
Conclusion: Five years total cost of HD is 37,616.98 USD with 358 days one year mean survival and 56.75 KDQOL
Key words: Regular hemodialysis, end-stage kidney disease, cost, QOL, survival


Biography:
I Made Rama Putra, born in Tabanan, Bali, Indonesia on October 14th, 1971. Graduated as medical doctor in 1997, and internist 2011. Work for district hospital bangli, rural area. Trainee nephrology since July 2016. Attending budapest nephrology school on august 2017. Write paper for pernefri meeting in 2015, 2016 and 2017

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