Out-of-pocket costs and productivity losses in haemodialysis and peritoneal dialysis from a patient interview survey in Taiwan

Chao Hsiun Tang, Hsi Hsien Chen, Ming Ju Wu, Bang Gee Hsu, Jer Chia Tsai, Chi Cheng Kuo, Shih Pi Lin, Tso Hsiao Chen, Yuh Mou Sue

Research output: Contribution to journalArticle

Abstract

Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.

Original languageEnglish
Article numbere023062
JournalBMJ Open
Volume9
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

Fingerprint

Peritoneal Dialysis
Health Expenditures
Taiwan
Renal Dialysis
Interviews
Costs and Cost Analysis
Nonparametric Statistics
Ambulatory Care
Medical Economics
Surveys and Questionnaires
Caregivers
Multicenter Studies
Outcome Assessment (Health Care)

Keywords

  • cost
  • haemodialysis
  • out-of-pocket cost
  • peritoneal dialysis
  • productivity loss

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Out-of-pocket costs and productivity losses in haemodialysis and peritoneal dialysis from a patient interview survey in Taiwan. / Tang, Chao Hsiun; Chen, Hsi Hsien; Wu, Ming Ju; Hsu, Bang Gee; Tsai, Jer Chia; Kuo, Chi Cheng; Lin, Shih Pi; Chen, Tso Hsiao; Sue, Yuh Mou.

In: BMJ Open, Vol. 9, No. 3, e023062, 01.03.2019.

Research output: Contribution to journalArticle

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abstract = "Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.",
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AU - Chen, Hsi Hsien

AU - Wu, Ming Ju

AU - Hsu, Bang Gee

AU - Tsai, Jer Chia

AU - Kuo, Chi Cheng

AU - Lin, Shih Pi

AU - Chen, Tso Hsiao

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N2 - Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.

AB - Objectives The total medical (economic) costs of haemodialysis (HD) and peritoneal dialysis (PD), including direct medical costs, out-of-pocket (OOP) costs and productivity losses, have become an important issue. This study aims to compare the direct non-medical costs and indirect medical costs of both modalities in Taiwan. Design and setting This multicentre study included cross-sectional interviews of patients over 20 years old and articulate, who had been continuously receiving long-Term HD or PD for more than 3 months between April 2015 and March 2016. Mann-Whitney U test, Wilcoxon rank-sum test and 1000 bootstrap procedures with replacement were used for analysis. Outcome measures Differences in OOP costs and productivity losses. Results There were 308 HD and 246 PD patients available for analysis. HD patients had significantly higher monthly OOP costs than PD patients after bootstrap procedures (NTD 5912 vs NTD 5225, p<0.001; NTD, new Taiwan dollars; 1 US dollar=30 NTD). Compared with PD patients, HD patients had higher monthly productivity losses after bootstrap procedures (NTD 14 150 vs NTD 11 611, p<0.001), resulting from more time spent seeking outpatient care (HD, 70.4 hours vs PD, 4.4 hours, p<0.001) and time spent by family caregivers for outpatient care (HD, 66.1 hours vs PD, 6.1 hours, p<0.001). The total costs per patient-month of HD and PD modalities, including OOP costs and productivity losses, were NTD 20 062 and NTD 16 836, respectively. Conclusions The HD modality has higher OOP costs and productivity losses than the PD modality in Taiwan.

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KW - productivity loss

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