Makhija Dilip U, Walton Surrey M, Mora Juan P, Sanabria Rafael M
Baxter Healthcare Corporation, Deerfield, IL, USA
Second City Outcomes Research, LLC., Chicago, IL, USA.
Perit Dial Int. 2017 Mar-Apr;37(2):165-169. doi: 10.3747/pdi.2016.00111. Epub 2016 Sep 28.
♦ BACKGROUND: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ METHODS: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013. Propensity score matching and regression analysis were performed to estimate the incremental cost of peritonitis. Patient months at risk, episodes of peritonitis pre- and post-CQI, and costs of CQI were obtained. Annual net savings of the CQI program were estimated based on the number of peritonitis events prevented. ♦ RESULTS: The incremental cost of a peritonitis episode was $250. In an 8-year period, peritonitis decreased from 1,837 episodes per 38,596 patient-months in 2006 to 841 episodes per 50,910 patient-months in 2014. Overall, the CQI program prevented an estimated 10,409 episodes of peritonitis. The cost of implementing the CQI program was $147,000 in the first year and $119,000 annually thereafter. Using a five percent discount rate, the net present value of the program was $1,346,431, with an average annual net savings of $207,027. The return on investment (i.e. total savings-program cost/program cost) of CQI was 169%. ♦ CONCLUSION: Continuous quality improvement initiatives designed to reduce rates of peritonitis have a strong potential to generate cost savings.
♦ 背景：关于腹膜炎的经济负担以及持续质量改进（CQI）项目对腹膜透析（PD）患者的经济影响，相关信息较少。本研究的目的是衡量腹膜炎的成本，并确定哥伦比亚PD CQI项目的净节省情况。♦ 方法：哥伦比亚的肾脏治疗服务（RTS）网络与Coomeva EPS合作，提供了2012年1月至2013年12月期间有和没有腹膜炎的PD患者的医疗资源利用数据。进行倾向得分匹配和回归分析以估计腹膜炎的增量成本。获取了处于风险中的患者月数、CQI前后的腹膜炎发作次数以及CQI的成本。基于预防的腹膜炎事件数量估计了CQI项目的年度净节省情况。♦ 结果：腹膜炎发作的增量成本为250美元。在8年期间，腹膜炎从2006年每38,596患者月1,837次发作降至2014年每50,910患者月841次发作。总体而言，CQI项目估计预防了10,409次腹膜炎发作。实施CQI项目的成本第一年为147,000美元，此后每年为119,000美元。使用5%的贴现率，该项目的净现值为1,346,431美元，平均每年净节省207,027美元。CQI的投资回报率（即总节省 - 项目成本/项目成本）为169%。♦ 结论：旨在降低腹膜炎发生率的持续质量改进举措具有显著的节省成本潜力。
