Retrospective Economic Analysis In The Cost And The Disease Burden Of Hemodialysis And Peritoneal Dialysis

The ESRD disease incidence rate is more and more high in the global scope.Its substitution treatment technology also in unceasingly enhancement and progress,But simultaneously its substitution treatment expense also unceasingly increases along with it..USA's research demonstrated that about 0.1%ESRD patient had consume the national 1%～2%medical service resources.Other Western developed countries findings are as similar as this.Its substitution treatment expense has become serious burden of each national,and therefore begin to carry on the economic appraisal to the kidney substitution treatment,seeks more economical and an effective method.Our country is the developing nation,the substitution treatment expense becomes the country and individual burden,By the influence of economy level of development and the payment way,At present the topic research of economic appraisal very short.Under this background,To analysis the two substitution method of treatment carry on a cost effect analysis—HD,CAPD so that we cold provide the more descided information for clinician and the ESRD patient.Objective To compare the expenses born by the two groups of people respectively undergoing hemodialysis and peritoneal dialysis,the effects Of their treatment and the influencing factors,analyze the economic disease burden Of the patients,and dissect the influence Of the current modes Of medical insurance compensations on the use Of the technique Of dialysis.To promote the development of peritoneal dialysis and medical insurance policies are more perfected. Materials and Methods The material originates from《Medical insurance information storehouse of Tianjin》Using the method Of retrospective survey,a comparison was made Of the age composition,treatment of choice status,treatment status,quality of life(Including the survival of life contrast,the major complications of the situation),exepenses burn by 3478 cases of hemodialysis and peritoneal dialysis who underwent theirfirst dialysis during the 2002—2007 period and the efects Of their treatment.And the choice of 100 cases from its state of the economy, the general condition after treatment,before and after treatment to compare working conditions.Excel and Database software was used for statistical analysis.According to estimates based on parameters of the requirements of statistical analysis.The cost of the state 95%was used to estimates confidence interval,analysis of varianc was used to comparing the two groups differences in treatment effect.And the influence Of compensation modes on the use Of the technique Of dialysis was studied by means of policy analysis.Results The kidney dialysis patient assumes the youth oriented tendency,Except medical expensive there was no marked difference between the groups respectively undergoing hemodialysis and peritoneal dialysis in mortality risks,life quality(There was no significant difference).Effect/expense of peritoneal dialysis is close or even more superior than hemodialysis,However on the clinical,For the most patient are suitable in two kinds of technologies,the peritoneal dialysis application actually far is lower than the hemodialysis.The disability degree Of the groups undergoing dialysis was high,their economic disease burn was heavy,and the phenomenon Of running into debt due to dialysis trealment Was widespread. Conclusion Differences in the modes Of medical insurance compensations for hemodialysis and peritonealdialysis expensive and hospital out-patient work of the lack of management in Peritoneal dialysis have led to the overuse Of the technique Of hemodialysis,Thus it is necessary to readjust and perfect policies related to dialysis in such aspects and Medical staff must be strengthen the correct guidance and management.To enhancement the last nephrosis prevention and the early dialysis treatment,including devotes in reduces causes the last stage nephrosis each kind of disease formation rate,the postponement nephrosis development for the last stage nephrosis as well as the choice being suitable early dialysis time and so on,made distribution treats funds more reasonable.