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Do kidney transplantations save money? – A study using a before–after design and multiple register-based data from Sweden

Jarl, Johan LU ; Desatnik, Peter; Peetz Hansson, Ulrika ; Prutz, Karl-Goran and Gerdtham, Ulf LU (2017) In CKJ: Clinical Kidney Journal
Abstract
Background: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective.

Method: A before–after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression.

Results: Altogether 66–79% of the expected... (More)
Background: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective.

Method: A before–after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression.

Results: Altogether 66–79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample.

Conclusion: Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dialysis, health care costs, kidney transplantation, Sweden
in
CKJ: Clinical Kidney Journal
publisher
Oxford University Press
ISSN
2048-8505
DOI
10.1093/ckj/sfx088
language
Swedish
LU publication?
yes
id
4a3e7514-c7bd-446b-81ce-05ef34ce47e6
date added to LUP
2017-12-08 14:10:43
date last changed
2017-12-08 14:59:40
@article{4a3e7514-c7bd-446b-81ce-05ef34ce47e6,
  abstract     = {Background: The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective.<br/><br/>Method: A before–after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression.<br/><br/>Results: Altogether 66–79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample.<br/><br/>Conclusion: Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy.},
  author       = {Jarl, Johan and Desatnik, Peter and Peetz Hansson, Ulrika  and Prutz, Karl-Goran and Gerdtham, Ulf},
  issn         = {2048-8505},
  keyword      = {dialysis,health care costs,kidney transplantation,Sweden},
  language     = {swe},
  publisher    = {Oxford University Press},
  series       = {CKJ: Clinical Kidney Journal},
  title        = {Do kidney transplantations save money? – A study using a before–after design and multiple register-based data from Sweden},
  url          = {http://dx.doi.org/10.1093/ckj/sfx088},
  year         = {2017},
}