The economic impact of acute kidney injury in England
Autor: | Donal O'Donoghue, Marion Kerr, Beverley Matthews, Michael Bedford |
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Rok vydání: | 2014 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent National Health Programs urologic and male genital diseases Young Adult Quality of life Health care medicine Prevalence Humans Economic impact analysis Intensive care medicine National data Aged Aged 80 and over Transplantation Inpatient care business.industry High mortality Acute kidney injury Health Care Costs Acute Kidney Injury Length of Stay Middle Aged medicine.disease female genital diseases and pregnancy complications Hospitalization England Nephrology Hospital admission Female Quality-Adjusted Life Years business Delivery of Health Care |
Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 29(7) |
ISSN: | 1460-2385 |
Popis: | Background. Acute kidney injury (AKI) is one of the most common complications affecting hospital inpatients around the world. It is associated with high mortality and adverse long-term outcomes, but there is uncertainty regarding its prevalence and cost. We estimate the prevalence of AKI in hospital inpatients in a universal health-care system, and the immediate and long-term impacts on survival, quality of life and health-care costs. Methods. We examined prevalence of AKI in inpatients using both routine national data for the National Health Service (NHS) in England, and laboratory data from East Kent Hospitals. We used regression analyses to estimate the impact of AKI on mortality and length of hospital stay, and a Markov model to estimate the impact on quality-adjusted life years and NHS costs. Results. AKI was recorded in 2.43% of hospital admissions in Hospital Episode Statistics (HES), but age- and genderstandardized estimates derived from laboratory data suggest the true prevalence may be more than five times as high (14.15%). We estimate that the annual number of excess inpatient deaths associated with AKI in England may be above 40 000. The annual cost of AKI-related inpatient care in England is estimated at £1.02 billion, just over 1% of the NHS budget. The lifetime cost of post-discharge care for people who had AKI during hospital admission in 2010–11 is estimated at £179 million. Conclusions. AKI prevalence in inpatients may be considerably higher than previously thought, and up to four fifths of cases may not be captured in routine hospital data. AKI is associated with large numbers of in-hospital deaths and with high NHS costs. Comparison of HES and East Kent data suggests that most of the cases recorded in HES may be relatively severe AKI (AKIN 2–3). |
Databáze: | OpenAIRE |
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