Objectives：The nephritis, nephritic syndrome and nephrosis are altogether ranked eighth among ten leading causes of death today; however, the cost of dialysis care is rated as the number one among the health care expenditures and has become a huge burden for the National Health Insurance in Taiwan. Most literatures focused on the differences in expenses for various dialysis treatments.The purpose of this study is to examine the cost-effectiveness analysis (CEA) of hemodialysis (HD) and peritoneal dialysis (PD) from the perspective of the Bureau of National Health Insurance.
Method：The sources of information, monitored about five to eight years individually, are based on the records of incident dialysis patients from the health insurance database, 1998 through 2007. Both t-test and ANOVA statistics techniques are applied to tell the differences of the average of total cost and survival weeks between HD and PD;thereafter, the CEA is also used to figure out the average survival expense per week for different kinds of dialysis therapy.
Results：The percentage of female patients was slightly higher than male among 2600 new initiated dialysis therapy cases. The mean ages for HD and PD were 62 and 52 years old respectively and the survival rates of HD and PD were similar. Survival rates of diabetes and/or hypertension patients were lower than disease-free ones. The average of total cost for HD was significantly higher than that for PD on control demographic factors in age group (P < 0.05); however, the survival rates were not significantly. The average of total cost for diabetes patients of HD was significantly higher than that for diabetes of PD on control demographic factors in age group (P < 0.05). The result of CEA shows that PD is more cost-effectiveness than HD on control demographic factors and comorbidity, i.e. the cost of survival required each week for HD is higher than that for PD.
Conclusions：Overall, after five to eight years follow-up period, the study shows that PD is the treatment with better cost-effectiveness; therefore, we suggest that initial dialysis patients with PD will be more cost-effectiveness.
