Utilization and Costs of Health Care in a Kidney Supportive Care Program
| Autor: | Luke B. Connelly, Wendy E. Hoy, Louise Purtell, P. Marcin Sowa, Ann Bonner, Helen Healy |
|---|---|
| Přispěvatelé: | Sowa P.M., Purtell L., Hoy W.E., Healy H.G., Bonner A., Connelly L.B. |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology patient-centered care End stage renal disease 03 medical and health sciences conservative pathway 0302 clinical medicine Renal Dialysis Multidisciplinary approach Diabetes mellitus Health care medicine Humans 030212 general & internal medicine Renal Insufficiency Chronic interdisciplinary model Dialysis health services utilization Aged Retrospective Studies Aged 80 and over end-stage renal disease Descriptive statistics business.industry Health Care Costs General Medicine Emergency department Middle Aged Patient Acceptance of Health Care medicine.disease Family medicine Kidney Failure Chronic Female Queensland business Delivery of Health Care Kidney disease |
| Zdroj: | Journal of Palliative Care. 35:176-184 |
| ISSN: | 2369-5293 0825-8597 |
| DOI: | 10.1177/0825859719868174 |
| Popis: | Kidney supportive care (KSC) is a patient-centered model of multidisciplinary care designed for patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Our goal was to characterize the types, frequencies, and costs of services accessed by patients enrolled in a KSC program. We analyzed health care utilization data prospectively collected from 102 patients who enrolled in the KSC program during the first 52 weeks of its existence. The data comprised program appointments, emergency department presentations, ambulance service use, outpatient visits, inpatient episodes, and dialysis treatments made within the Brisbane area of Metro North. Costs of resource use were estimated using Queensland Health funding principles and guidelines. Analyses included descriptive statistics, correlations, and multivariate regressions. During the median program participation of 22 weeks, patients had 3975 contacts with health care, with the total value of services amounting to nearly A$3 million. Dialysis treatments accounted for 70% of visits and 49% of costs. Patients receiving dialysis had higher utilization of outpatient services and associated cost, compared to patients who were not dialyzed. The presence of diabetes and the choice of conservative pathway were both predictors of higher frequency and cost of services. Longer program participation was associated with lower weekly utilization and cost. The program attracted patients representing various characteristics, pathways, needs, and outcomes. Exploring these patterns will enable better understanding of the patient population and improved service planning, in KSC and similar programs that aim to comprehensively address the needs of patients with advanced CKD and ESKD. |
| Databáze: | OpenAIRE |
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