Nephrology Department, University Hospital Complex of Vigo, Alto de Puxeiros s/n, Vigo, Pontevedra, Spain.
Nefrologia. 2011;31(6):656-63. doi: 10.3265/Nefrologia.pre2011.Oct.11032.
Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD).
To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the relationship between the cost of the agreement and the cost of consumables used in continuous ambulatory peritoneal dialysis (CAPD) with bicarbonate.
The cost of the outsourcing agreements and the staff was obtained from official publications. The cost of PD and medical transport were calculated using health service data for one month and extrapolating it to one year. The cost of CAPD consumables was provided by the suppliers. The added value was calculated from the investments generated for each agreement treating 40 patients.
Expressed as patient/year, the mean costs for treatment were €21595 and €25664 in HD and PD, respectively. Medical transport varied between €3323 and €6338, while those of the CAPD agreement and consumables were €19268 and €12057, respectively. The added value was greater with the HD agreement, especially considering the jobs created.
One cannot generalise that the cost of PD, which is significantly influenced by prescriptions, is lower than that of HD. It would be appropriate to review the additional cost to consumables in the CAPD agreement. The added value generated by dialysis agreements should be considered in future studies and in health planning. More controlled studies are needed to better understand this issue.
尽管西班牙关于透析成本的研究结果存在差异，但人们认为腹膜透析（PD）比血液透析（HD）更有效。
分析加利西亚血液透析和腹膜透析外包协议、血液透析医疗运输的成本和附加值，以及协议成本与使用碳酸氢盐的持续性非卧床腹膜透析（CAPD）耗材成本之间的关系。
从官方出版物中获取外包协议和人员成本。使用一个月的卫生服务数据计算 PD 和医疗运输成本，并将其外推至一年。CAPD 耗材成本由供应商提供。从每个协议为 40 名患者治疗产生的投资中计算附加值。
以患者/年为单位，HD 和 PD 的治疗平均成本分别为 21595 欧元和 25664 欧元。医疗运输费用在 3323 欧元至 6338 欧元之间，而 CAPD 协议和耗材的成本分别为 19268 欧元和 12057 欧元。HD 协议的附加值更高，尤其是考虑到所创造的就业机会。
不能一概而论地认为 PD 的成本（受处方影响很大）低于 HD。应审查 CAPD 协议中耗材的额外成本。未来的研究和卫生规划应考虑透析协议产生的附加值。需要进行更多的对照研究，以更好地理解这个问题。
