Cost of conservative management in patients with end stage kidney disease who decline dialysis: lessons from a multi-centre observational study in the UK

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      Paper 1 - Cost of conservative management in patients with end stage kidney disease who decline dialysis: lessons from a multi-centre observational study in the UK 1. Glenn Phair, Northern Ireland Clinical Trials Unit 2. Ashley Agus, Northern Ireland Clinical Trials Unit 3. Professor Charles Normand, Trinity College Dublin 4. Professor Kevin Brazil, Queen's University Belfast 5. Dr Aine Burns, Royal Free Hospital 6. Professor Paul Roderick, University of Southampton 7. Mr Colin Thompson, Northern Ireland Kidney Patient Association, Northern, Ireland 8. Professor Peter Maxwell, Belfast City Hospital and Queen's University Belfast 9. Professor Magdi Yaqoob, The Royal London Hospital & Queen Mary University of London 10. Dr Helen Noble, Queen's University Belfast Background: To date research has looked at the cost of providing renal replacement therapy, but no previous study has examined the cost of conservative management. This study estimated the costs to the National Health Service (NHS) of providing conservative management over a 12 month period to patients with end stage chronic kidney disease who had declined renal replacement therapy. Methods: This was a descriptive cost analysis alongside a UK based multicentre observational study conducted. Forty-two patients were recruited to the study between 30 March 2015 and 26 May 2016 and were provided with service use logs to prospectively record their use of community, hospital, and carer services in 3 month intervals up to 12 months. A mean cost per patient was calculated for each 3 month time period based on the resources used and 12 month costs were calculated for patients with complete data at one year. Results: Almost 60% of patients recruited were female and the mean age was 79.8 years. Mean cost per patient for each 3 month period was £1622 (0-3 months), £1008 (3-6 months), £554 (6-9 months) and £2626 (9-12 months). Hospital costs constituted the biggest proportion of total costs at the 3, 9 and 12 month time periods, with formal carers being the largest component at 6 months. In patients with complete data (n=8) the total cost per patient for the 12 month period was £5511, with costs of formal carers making up 57% of this. Conclusions: The results show the NHS costs incurred due to provision of conservative management in patients with end stage kidney disease and the specific services used by this population. This information is valuable in future health service planning and for use in countries with a comparable health service structure. A number of options could be explored in future studies: administrative databases to obtain information instead of resource logs; an attempt to reflect the wider cost of informal care; examine the decision-making process in deciding which treatment patients choose; and making direct cost comparisons between renal replacement therapy and conservative management.
      Original languageEnglish
      Pages1
      Number of pages1
      StatePublished - 14 Sep 2017
      EventHealth Economics Association of Ireland Meeting - Belfast, United Kingdom

      Conference

      ConferenceHealth Economics Association of Ireland Meeting
      CountryUnited Kingdom
      CityBelfast
      Period18/09/2017 → …

      ID: 134957722