Sennfält Karin, Magnusson Martin, Carlsson Per
Center for Medical Technology Assessment, Linköping University, Sweden.
Perit Dial Int. 2002 Jan-Feb;22(1):39-47.
Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population.
Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective.
All dialysis departments in the southeastern health-care region of Sweden.
136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study; 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study.
Cost per life year and cost per quality-adjusted life year.
The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21-40 years, a 31% difference in the age group 41-60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment.
The cost-utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.
我们的目的是比较特定人群中血液透析（HD）和腹膜透析（PD）的健康相关生活质量和成本。
决策树建模，以估计慢性肾衰竭患者在开始治疗后的5年中，HD和PD这两种治疗策略的总成本和效果。在一项回顾性匹配记录研究中描绘了事件过程和医疗保健消耗情况。通过生活质量问卷（欧洲五维度健康量表）从匹配人群中获取健康状况数据。该研究采用社会视角。
瑞典东南部医疗保健地区的所有透析科室。
136例肾衰竭患者，包括68对匹配对，纳入回顾性记录研究；81例肾衰竭患者，包括27个匹配三胞胎，纳入前瞻性问卷调查研究。
每生命年成本和每质量调整生命年成本。
在所有分析的年龄组中，PD的每质量调整生命年成本较低。在21 - 40岁年龄组中差异为12%，在41 - 60岁年龄组中差异为31%，在61岁及以上年龄组中差异为11%。在开始治疗后的前5年中，腹膜透析和血液透析导致的移植频率相似（分别为50%和41%），预期生存期相似（分别为3.58年和3.56年）。
对于有条件选择PD和HD的患者，成本效益比最有利于将PD作为主要治疗方法。
