Abstract:
The cost of kidney transplantation (KT) and its follow-up care greatly exceeds the mean annual family income. Governmental support during the post-transplant period is needed. This study aimed to identify the drivers of cost during the 1st year after KT. The records of 129 adult Filipino KT recipients over 2 years in a single center were reviewed to determine the total cost for the 1st year after KT, such as diagnostics, medications, supplies, and professional fees. Univariate and multivariate analyses were carried out to determine the economic impact of the baseline characteristics, comorbidities, and events after KT. The direct costs of care were significantly higher among patients aged >40 years (P = 0.009), those with diabetic kidney disease as the primary renal disease (P <0.0001), and those with a high Charlson comorbidity index (P = 0.001). Multivariate regression analysis showed that patients with diabetes mellitus paid US$ 6813.6 more, and those hospitalized for any infection spent US$ 3877.4 more than those without comorbid conditions or complications. The results showed that diabetes mellitus and hospitalization for any infection significantly impacted the cost of follow-up care. Health-care policies that can aid patients after KT are needed to minimize expenditures and avoid complications.
摘要:
肾移植(KT)及其后续护理的费用大大超过了家庭的平均年收入。移植后需要政府的支持。本研究旨在确定KT后第一年的成本驱动因素。对129名菲律宾KT成人接受者在一个中心超过2年的记录进行了审查,以确定KT后第一年的总成本,比如诊断,药物,用品,和专业费用。进行了单变量和多变量分析,以确定基线特征的经济影响,合并症,以及KT之后的事件。在年龄>40岁的患者中,护理的直接费用明显较高(P=0.009)。以糖尿病肾病为主要肾病者(P<0.0001),以及Charlson合并症指数较高的患者(P=0.001)。多因素回归分析显示,糖尿病患者多付6813.6美元,因任何感染而住院的患者比没有合并症或并发症的患者多花了3877.4美元。结果显示,糖尿病和任何感染的住院治疗都会显著影响后续护理的成本。需要可以帮助KT后患者的医疗保健政策,以最大程度地减少支出并避免并发症。