We have located links that may give you full text access.
Five-year cost-utility analysis of acute renal replacement therapy: a societal perspective.
Intensive Care Medicine 2013 March
PURPOSE: Assessment of the cost utility (CU) of acute renal replacement therapy (RRT) from a societal perspective during a 5-year follow-up.
METHODS: This was a cross-sectional cohort study in a medical-surgical intensive care unit and an acute RRT unit of 410 consecutive patients treated with acute RRT in Helsinki University Hospital in 2000-2002. Five-year survival and health-related quality of life (HRQoL) were assessed and used to calculate quality-adjusted life years (QALYs) in two ways. They were first calculated for the 5-year follow-up period and, second, estimated for the expected lifetime. HRQoL was assessed by the EuroQol (EQ-5D) in 2003. The cost analysis included hospital costs during index hospitalization along with hospital and societal costs for the following 5 years. The CU ratio was determined as total costs divided by gained QALYs.
RESULTS: Median survival time for all patients was 0.20 years and the EQ-5D index score was 0.68, 0.18 lower than that of the age- and gender-matched general population. All RRT-treated patients gained 0.10 QALYs/patient and hospital survivors 2.54 QALYs in 5 years. Overall the CU ratio was poor [5 year median 271,116 (29,782-2,177,581) €/QALY]. However, it was acceptable (less than 50,000 €/QALY) in patients who survived for more than a year and did not need chronic RRT. Cost utility decreased with increasing age exceeding 1.0 million €QALY in the older groups.
CONCLUSIONS: In general, the CU ratio of acute RRT is poor. However, it is acceptable in patients with renal recovery who survive for more than 1 year.
METHODS: This was a cross-sectional cohort study in a medical-surgical intensive care unit and an acute RRT unit of 410 consecutive patients treated with acute RRT in Helsinki University Hospital in 2000-2002. Five-year survival and health-related quality of life (HRQoL) were assessed and used to calculate quality-adjusted life years (QALYs) in two ways. They were first calculated for the 5-year follow-up period and, second, estimated for the expected lifetime. HRQoL was assessed by the EuroQol (EQ-5D) in 2003. The cost analysis included hospital costs during index hospitalization along with hospital and societal costs for the following 5 years. The CU ratio was determined as total costs divided by gained QALYs.
RESULTS: Median survival time for all patients was 0.20 years and the EQ-5D index score was 0.68, 0.18 lower than that of the age- and gender-matched general population. All RRT-treated patients gained 0.10 QALYs/patient and hospital survivors 2.54 QALYs in 5 years. Overall the CU ratio was poor [5 year median 271,116 (29,782-2,177,581) €/QALY]. However, it was acceptable (less than 50,000 €/QALY) in patients who survived for more than a year and did not need chronic RRT. Cost utility decreased with increasing age exceeding 1.0 million €QALY in the older groups.
CONCLUSIONS: In general, the CU ratio of acute RRT is poor. However, it is acceptable in patients with renal recovery who survive for more than 1 year.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app