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Five-year cost-utility analysis of acute renal replacement therapy: a societal perspective.
- Source :
-
Intensive Care Medicine . Mar2013, Vol. 39 Issue 3, p406-413. 8p. 1 Diagram, 4 Charts, 1 Graph. - Publication Year :
- 2013
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 39
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 85676565
- Full Text :
- https://doi.org/10.1007/s00134-012-2760-4