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Hemodialysis and Peritoneal Dialysis in Germany from a Health Economic View—A Propensity Score Matched Analysis

Author

Listed:
  • Arim Shukri

    (Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50923 Cologne, Germany)

  • Thomas Mettang

    (Kidney Center Wiesbaden, 65189 Wiesbaden, Germany)

  • Benjamin Scheckel

    (Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50923 Cologne, Germany)

  • Isabell Schellartz

    (Institute of Health Care Research, Rhineland State Council, 51109 Cologne, Germany)

  • Dusan Simic

    (Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50923 Cologne, Germany)

  • Nadine Scholten

    (Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Medicine, University of Cologne, 50923 Cologne, Germany)

  • Martin Müller

    (Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
    Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3012 Bern, Switzerland
    These authors contributed equally to this work.)

  • Stephanie Stock

    (Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine, University Hospital Cologne, University of Cologne, 50923 Cologne, Germany
    These authors contributed equally to this work.)

Abstract

Background: Hemodialysis (HD) and peritoneal dialysis (PD) are deemed medically equivalent for therapy of end-stage renal disease (ESRD) and reimbursed by the German statutory health insurance (SHI). However, although the home dialysis modality PD is associated with higher patient autonomy than HD, for unknown reasons, PD uptake is low in Germany. Hence, we compared HD with PD regarding health economic outcomes, particularly costs, as potentially relevant factors for the predominance of HD. Methods: Claims data from two German health insurance funds were analysed in a retrospective cohort study regarding the prevalence of HD and PD in 2013–2016. Propensity score matching created comparable HD and PD groups ( n = 436 each). Direct annual health care costs were compared. A sensitivity analysis included a comparison of different matching techniques and consideration of transportation costs. Additionally, hospitalisation and survival were investigated using Poisson regression and Kaplan-Meier curves. Results: Total direct annual average costs were higher for HD (€47,501) than for PD (€46,235), but not significantly ( p = 0.557). The additional consideration of transportation costs revealed an annual cost advantage of €7000 for PD. HD and PD differed non-significantly in terms of hospitalisation and survival rates ( p = 0.610/ p = 0.207). Conclusions: PD has a slight non-significant cost advantage over HD, especially when considering transportation costs.

Suggested Citation

  • Arim Shukri & Thomas Mettang & Benjamin Scheckel & Isabell Schellartz & Dusan Simic & Nadine Scholten & Martin Müller & Stephanie Stock, 2022. "Hemodialysis and Peritoneal Dialysis in Germany from a Health Economic View—A Propensity Score Matched Analysis," IJERPH, MDPI, vol. 19(21), pages 1-11, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:14007-:d:955453
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    References listed on IDEAS

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    1. Catrin Treharne & Frank Liu & Murat Arici & Lydia Crowe & Usman Farooqui, 2014. "Peritoneal Dialysis and In-Centre Haemodialysis: A Cost-Utility Analysis from a UK Payer Perspective," Applied Health Economics and Health Policy, Springer, vol. 12(4), pages 409-420, August.
    2. Werner Kleophas & Helmut Reichel, 2007. "International study of health care organization and financing: development of renal replacement therapy in Germany," International Journal of Health Economics and Management, Springer, vol. 7(2), pages 185-200, September.
    3. Isabell Schellartz & Sunita Mettang & Arim Shukri & Nadine Scholten & Holger Pfaff & Thomas Mettang, 2021. "Early Referral to Nephrological Care and the Uptake of Peritoneal Dialysis. An Analysis of German Claims Data," IJERPH, MDPI, vol. 18(16), pages 1-10, August.
    4. Ho, Daniel & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2011. "MatchIt: Nonparametric Preprocessing for Parametric Causal Inference," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 42(i08).
    5. Chu-Chun Hsu & Chiu-Ching Huang & Yue-Cune Chang & Jin-Shuen Chen & Wen-Chen Tsai & Kwua-Yun Wang, 2020. "A comparison of quality of life between patients treated with different dialysis modalities in Taiwan," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-11, January.
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