台湾地区腹膜透析和血液透析患者的终身费用。
Lifetime costs for peritoneal dialysis and hemodialysis in patients in Taiwan.
机构信息
Department of Internal Medicine,1 National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei;
出版信息
Perit Dial Int. 2013 Nov-Dec;33(6):671-8. doi: 10.3747/pdi.2012.00081. Epub 2013 May 1.
BACKGROUND
This study compared the lifetime costs for peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan.
METHODS
Using the National Health Insurance (NHI) database of all end-stage renal disease patients on maintenance dialysis registered from July 1997 to December 2005, we matched eligible PD patients with eligible HD patients on age, sex, and diabetes status. The matched patients were followed until 31 December 2006. Patients were excluded if they were less than 18 years of age, had been diagnosed with cancer before dialysis, or had been dialyzed at centers or clinics other than hospitals. Outcomes-including life expectancy, total lifetime costs, and costs per life-year paid by the NHI-were estimated and compared.
RESULTS
The 3136 pairs of matched PD and HD patients had a mean age of 53.2 ± 15.4 years. The total lifetime cost for PD patients (US$139 360 ± US$8 336) was significantly lower than that for HD patients (US$185 235 ± US$9 623, p < 0.001). Except for patients with diabetes (who had a short life expectancy), the total lifetime cost was significantly lower for PD patients than for HD patients regardless of sex and age (p < 0.01).
CONCLUSION
In Taiwan, the total lifetime costs paid by the NHI were lower for PD than for HD patients.
背景
本研究比较了台湾腹膜透析（PD）和血液透析（HD）患者的终身费用。
方法
使用国家健康保险（NHI）数据库中所有 1997 年 7 月至 2005 年 12 月登记的维持性透析终末期肾病患者，我们按照年龄、性别和糖尿病状态匹配 PD 患者和 HD 患者。匹配患者随访至 2006 年 12 月 31 日。排除年龄小于 18 岁、透析前诊断患有癌症或在医院以外的中心或诊所透析的患者。估计并比较了包括预期寿命、总终身费用和 NHI 支付的每生命年费用在内的结果。
结果
3136 对匹配的 PD 和 HD 患者的平均年龄为 53.2 ± 15.4 岁。PD 患者的总终身费用（139360 美元±8336 美元）明显低于 HD 患者（185235 美元±9623 美元，p < 0.001）。除糖尿病患者（预期寿命较短）外，无论性别和年龄如何，PD 患者的总终身费用均明显低于 HD 患者（p < 0.01）。
结论
在台湾，NHI 支付的 PD 总终身费用低于 HD 患者。
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