Domínguez J, Harrison R, Atal R
Facultad de Medicina, Departamento de Urología, Pontificia Universidad Católica de Chile, Santiago, Chile.
Transplant Proc. 2011 Jul-Aug;43(6):2300-4. doi: 10.1016/j.transproceed.2011.06.006.
In this paper we have estimated the cost savings for the health care system and quality-of-life improvement for patients from an increased number of kidney transplants in Chile. We compared the present value of dialysis and transplantation costs and quality of life over a 20-year horizon.
We used Markov models and introduced some degree of uncertainty in the value of some of the parameters that built the model. Using Monte Carlo simulations, we estimated the confidence intervals for our results.
Our estimates suggested that a kidney transplant showed an expected savings value of US$28,000 for the health care system. If the quality-of-life improvement was also considered, the expected savings rise to US$ 102,000. These results imply that increasing donation rate by 1 donor per million population would achieve an estimated cost saving of US$827,000 per year, or near US$3 million per year considering the effect on the quality of life.
These results demonstrated that kidney transplantation along with a better quality of life for patients are a cost-saving decision for developing countries.
在本文中，我们估算了智利因肾移植数量增加而为医疗保健系统节省的成本以及患者生活质量的改善情况。我们比较了20年内透析和移植成本的现值以及生活质量。
我们使用马尔可夫模型，并在构建模型的一些参数值中引入了一定程度的不确定性。通过蒙特卡洛模拟，我们估算了结果的置信区间。
我们的估算表明，肾移植对医疗保健系统而言预期节省价值为28,000美元。如果还考虑生活质量的改善，预期节省额将增至102,000美元。这些结果意味着，每百万人口捐赠者数量增加1名，估计每年可节省成本827,000美元，考虑到对生活质量的影响，则每年接近300万美元。
这些结果表明，肾移植以及患者更高的生活质量对发展中国家来说是一个节省成本的决策。
