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Titolo	ASN 2005 [PUB460] Cost-Effectiveness of the Home Plus Program To Promote Peritoneal Dialysis
Autore	Robert R. Quinn, Ethel Doyle, Elizabeth P. Richardson, Braden J. Manns, Matthew J. Oliver Department of Medicine, Sunnybrook & Women\\\'s College Health Sciences Centre, Toronto, ON, Canada; Health Policy, Management, & Evaluation, University of Toronto, Toronto, ON, Canada; Departments of Medicine & Community Health Sciences, Foothills Medical Centre, Calgary, AB, Canada; University of Calgary, Calgary, AB, Canada
Referenza	ASN 2005 - 8.11.2005 - 13.11.2005 Philadelphia, Pennsylvania, USA
Contenuto	We examined the cost-effectiveness of the Home Plus Program. The objective of this pilot program was to determine the feasibility of providing home care assistance to patients with barriers to traditional peritoneal dialysis (PD) in an attempt to increase PD utilization. Patients who consented to participate in the Home Plus program underwent a multidisciplinary assessment and modality education program and were offered up to 2 home visits per day, 7 days per week to support home dialysis as needed. Patients were then given the choice of traditional, in-centre hemodialysis (HD) or peritoneal dialysis (PD) with assistance. The costs incurred by patients choosing PD were compared to those who chose HD and included those associated with modality education and training, access creation and interventions, chronic dialysis treatments, laboratory and radiologic investigations, medications, and hospitalizations. All costs are expressed in 2004 Canadian dollars. Table 1. Results and Selected Costs HEMODIALYSIS PERITONEAL DIALYSIS N 11 14 MEAN AGE years (range) 70 (48-87) 70 (51-93) MEAN CHARLSON INDEX SCORE (range) 5.1 (3-9) 4.8 (2-9) MEAN # HOME CARE VISITS per month 0.4 14.4 TOTAL PT-MONTHS follow-up 92 62 TOTAL COST per pt-year $88,238 $72,446 OPERATING COST per pt-year $75,792 $52,155 HOSPITALIZATION COSTS per pt-year $8,964 $2,484 ACCESS RELATED COSTS per pt-year $2,586 $4,088 COST HOME VISITS per pt-year $205 $8,500 *Cost expressed in 2004 Canadian Dollars 66.7% of eligible patients without a contraindication chose PD. The average cost of providing assistance to PD patients with barriers to traditional PD was $8500 per pt-year of therapy. Despite this additional cost, PD remained less expensive than HD. The Home Plus Program appears to be a cost-effective means by which to increase PD utilization.
Data	20.12.2005

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