Cost-effectiveness of interventions for end-stage renal disease

Detalhes bibliográficos
Autor(a) principal: Arredondo, Armando
Data de Publicação: 1998
Outros Autores: Rangel, Ricardo, Icaza, Esteban de
Tipo de documento: Artigo
Idioma: spa
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/24418
Resumo: OBJECTIVE: The study reports the cost-effectiveness results of end-stage renal disease (ESDR) patients in Mexico in terms of years of life gained and quality of life and the economic cost with regards to three treatment alternatives that could be considered mutually exclusive: continuous peritoneal ambulatory dialysis (CAPD), hemodialysis (HD) and renal transplant (RT). METHOD: The economic costs were calculated by using the average cost case-management methodology and further, the probable of life expectancy and the quality of life were cross-sectionally assessed by means of the Quality Adjusted Life Years (QALY) measured by the Rosser Index. RESULTS: The results show that economic costs in US$ of the three treatment alternatives were: CAPD $5,643.07, HD $9,631.60, and RT $3,021.63. The probability of life expectancy for CAPD and RT for the first and third year were: 86.2% and 66.9%, and 89.9% and 79.6%, respectively. The QALY scores for patients were: CAPD 0.8794, HD 0.8640, and RT 0.9783. CONCLUSION: The intervention with the highest cost-effectiveness coefficient was the renal transplant (3,088.69), followed by the CAPD (6,416.95) and HD (11,147.68). A significant difference was found between the transplanted patients and patients undergoing dialysis. Finally, this study concluded that the RT offers the least expensive alternative and the greatest number of years of life gained as well as providing significant changes in the quality of life of ESRD patients.
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spelling Cost-effectiveness of interventions for end-stage renal disease Costo-efectividad de intervenciones para insuficiencia renal crónica terminal Insuficiência renal crônica^i3^seconoAnálise custo-benefícioQualidade de vidaInsuficiencia renal crónicaAnálisis de costo-beneficioCalidad de vidaKidney failure^i2^schroKidney failure^i2^seconCost-benefit analysisQuality of life OBJECTIVE: The study reports the cost-effectiveness results of end-stage renal disease (ESDR) patients in Mexico in terms of years of life gained and quality of life and the economic cost with regards to three treatment alternatives that could be considered mutually exclusive: continuous peritoneal ambulatory dialysis (CAPD), hemodialysis (HD) and renal transplant (RT). METHOD: The economic costs were calculated by using the average cost case-management methodology and further, the probable of life expectancy and the quality of life were cross-sectionally assessed by means of the Quality Adjusted Life Years (QALY) measured by the Rosser Index. RESULTS: The results show that economic costs in US$ of the three treatment alternatives were: CAPD $5,643.07, HD $9,631.60, and RT $3,021.63. The probability of life expectancy for CAPD and RT for the first and third year were: 86.2% and 66.9%, and 89.9% and 79.6%, respectively. The QALY scores for patients were: CAPD 0.8794, HD 0.8640, and RT 0.9783. CONCLUSION: The intervention with the highest cost-effectiveness coefficient was the renal transplant (3,088.69), followed by the CAPD (6,416.95) and HD (11,147.68). A significant difference was found between the transplanted patients and patients undergoing dialysis. Finally, this study concluded that the RT offers the least expensive alternative and the greatest number of years of life gained as well as providing significant changes in the quality of life of ESRD patients. OBJETIVO: Analisó el costo-efectividad en intervenciones para pacientes con insuficiencia renal crónica terminal (IRCT) en términos de los costos económicos de cada intervención, los años de vida ganados y la calidad de vida que generan tres alternativas comparables y mutuamente excluyentes: diálisis peritoneal contínua ambulatoria (DPCA), la hemodiálisis (HD) y el trasplante renal (TR). MÉTODO: El diseño del estudio fue de tipo longitudinal. Los costos de cada intervención se determinaron mediante la técnica de manejo de caso promedio. Las medidas para evaluar los criterios de efectividad elegidos fueron la probabilidad de sobrevida y el Año de Vida Ajustado por Calidad (QALY, Quality Adjusted Life Year) medido por el Indice de Rosser. RSULTADOS: Los costos de manejo anual de caso fueron: diálisis peritoneal $5,643.07, hemodiálisis $9,631.60 y trasplante $3,021.63. En cuanto a la efectividad, la sobrevida del injerto de trasplante renal resultó de 89,9% y 79,6% a uno y tres años respectivamente, mientras que los pacientes sometidos a DPCA tienen una sobrevida de 86,2% y 66,9% a un año y a tres años respectivamente. En cuanto a los QALY's, los resultados para cada intervención fueron: DPCA 0,879; HD 0,864; y para el TR 0,978. CONCLUSIÓN: La intervención más costo-efectiva resultó el trasplante renal con un coeficiente de 3,088.69, seguido de la DPCA y la hemodiálisis, cuyos coeficientes fueron de 6,416.95 y 11,147.68 respectivamente. Por lo tanto se recomienda promover y utilizar el trasplante renal como la intervención más costo-efectiva para pacientes con IRCT. OBJETIVO: Analisar o custo-efetividade de intervenções realizadas em pacientes com insuficiência renal crônica terminal (IRCT) quanto a custos econômicos de cada intervenção, anos de vida ganhos e qualidade de vida que geram três alternativas comparáveis e mutuamente excluentes: diálise peritoneal contínua ambulatória (DPCA), hemodiálise (HD) e transplante renal (TR). MÉTODO: O desenho do estudo foi do tipo longitudinal. Os custos de cada intervenção foram determinados mediante a técnica de manejo de caso promédio. As medidas para avaliar os critérios de efetividade elegidos foram a probabilidade de sobrevida e o Ano de Vida Ajustado por Qualidade (QALY, Quality Adjusted Life Year) medido pelo Índice de Rosser. RESULTADOS: Os custos do manejo anual de caso foram: diálise peritoneal US$5,643.07, hemodiálise US$9,631.60 e transplante US$3,021.63. Quanto à efetividade, a sobrevida do transplante renal resultou em 89,9% e 79,6% para um e três anos, respectivamente, enquanto que os pacientes submetidos a DPCA têm uma sobrevida de 86,2% e 66,9% para um ano e três anos, respectivamente. Quanto aos QALY's, os resultados para cada intervenção foram: DPCA 0,879; HD 0,864; e para o TR 0,978. CONCLUSÃO: A intervenção mais custo-efetivo mostrou ser o transplante renal com um coeficiente de 3,088.69 seguido da DPCA e da hemodiálise, cujos coeficientes foram de 6,416.95 e 11,147.68, respectivamente. Recomenda-se promover e utilizar o transplante renal como a intervenção mais custo-efetivo para pacientes com IRCT. Universidade de São Paulo. Faculdade de Saúde Pública1998-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2441810.1590/S0034-89101998000600009Revista de Saúde Pública; Vol. 32 No. 6 (1998); 556-565 Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 556-565 Revista de Saúde Pública; v. 32 n. 6 (1998); 556-565 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPspahttps://www.revistas.usp.br/rsp/article/view/24418/26342Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessArredondo, ArmandoRangel, RicardoIcaza, Esteban de2012-05-29T17:01:13Zoai:revistas.usp.br:article/24418Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T17:01:13Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Cost-effectiveness of interventions for end-stage renal disease
Costo-efectividad de intervenciones para insuficiencia renal crónica terminal
title Cost-effectiveness of interventions for end-stage renal disease
spellingShingle Cost-effectiveness of interventions for end-stage renal disease
Arredondo, Armando
Insuficiência renal crônica^i3^secono
Análise custo-benefício
Qualidade de vida
Insuficiencia renal crónica
Análisis de costo-beneficio
Calidad de vida
Kidney failure^i2^schro
Kidney failure^i2^secon
Cost-benefit analysis
Quality of life
title_short Cost-effectiveness of interventions for end-stage renal disease
title_full Cost-effectiveness of interventions for end-stage renal disease
title_fullStr Cost-effectiveness of interventions for end-stage renal disease
title_full_unstemmed Cost-effectiveness of interventions for end-stage renal disease
title_sort Cost-effectiveness of interventions for end-stage renal disease
author Arredondo, Armando
author_facet Arredondo, Armando
Rangel, Ricardo
Icaza, Esteban de
author_role author
author2 Rangel, Ricardo
Icaza, Esteban de
author2_role author
author
dc.contributor.author.fl_str_mv Arredondo, Armando
Rangel, Ricardo
Icaza, Esteban de
dc.subject.por.fl_str_mv Insuficiência renal crônica^i3^secono
Análise custo-benefício
Qualidade de vida
Insuficiencia renal crónica
Análisis de costo-beneficio
Calidad de vida
Kidney failure^i2^schro
Kidney failure^i2^secon
Cost-benefit analysis
Quality of life
topic Insuficiência renal crônica^i3^secono
Análise custo-benefício
Qualidade de vida
Insuficiencia renal crónica
Análisis de costo-beneficio
Calidad de vida
Kidney failure^i2^schro
Kidney failure^i2^secon
Cost-benefit analysis
Quality of life
description OBJECTIVE: The study reports the cost-effectiveness results of end-stage renal disease (ESDR) patients in Mexico in terms of years of life gained and quality of life and the economic cost with regards to three treatment alternatives that could be considered mutually exclusive: continuous peritoneal ambulatory dialysis (CAPD), hemodialysis (HD) and renal transplant (RT). METHOD: The economic costs were calculated by using the average cost case-management methodology and further, the probable of life expectancy and the quality of life were cross-sectionally assessed by means of the Quality Adjusted Life Years (QALY) measured by the Rosser Index. RESULTS: The results show that economic costs in US$ of the three treatment alternatives were: CAPD $5,643.07, HD $9,631.60, and RT $3,021.63. The probability of life expectancy for CAPD and RT for the first and third year were: 86.2% and 66.9%, and 89.9% and 79.6%, respectively. The QALY scores for patients were: CAPD 0.8794, HD 0.8640, and RT 0.9783. CONCLUSION: The intervention with the highest cost-effectiveness coefficient was the renal transplant (3,088.69), followed by the CAPD (6,416.95) and HD (11,147.68). A significant difference was found between the transplanted patients and patients undergoing dialysis. Finally, this study concluded that the RT offers the least expensive alternative and the greatest number of years of life gained as well as providing significant changes in the quality of life of ESRD patients.
publishDate 1998
dc.date.none.fl_str_mv 1998-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24418
10.1590/S0034-89101998000600009
url https://www.revistas.usp.br/rsp/article/view/24418
identifier_str_mv 10.1590/S0034-89101998000600009
dc.language.iso.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24418/26342
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 32 No. 6 (1998); 556-565
Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 556-565
Revista de Saúde Pública; v. 32 n. 6 (1998); 556-565
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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