Epidemiology and hospitalization costs of chronic kidney disease in Romania.

IF 2.7 3区 经济学 Q1 ECONOMICS
Ildiko Aliz Bradacs, László-István Bába, László Lorenzovici, Andreea Mihaela Precup, Szabolcs Farkas- Ráduly, Gyongyi Tar, Vasile Nastase, Lucia Georgeta Daina, Raul Bozu, Gyula Jozsef Nagy, Dimitrie Cristian Siriopol, Dorel Sandesc, Ovidiu Horea Bedreag, Florin Buicu, Gabriel Mircescu, Gener Ismail
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引用次数: 0

Abstract

Background: Chronic kidney disease or chronic renal failure is a progressive condition defined as abnormalities of kidney structure or function, present for longer than 3 months. It is estimated to affect more than 10% of the general population worldwide. Management of CKD represents an especially large burden for the health systems of low- and middle-income countries, and it has been recognized as a leading public health problem. Previous research articles reported an age-adjusted prevalence of 7.6% for Romania, but the hospital costs generated by CKD are unknown. The present research article aimed to measure the hospital costs and one-year national healthcare budget impact of CKD, excepting the chronic care costs of RRTs.

Methods: In this retrospective study we reviewed the electronic health records of 4 University, 3 County and 5 City hospitals from 1st of January 2019 to 31st of December 2019 in order to calculate costs related to hospitalization due to chronic kidney disease. Inclusion criteria were defined as: CKD-related diagnostic codes or dialysis-related procedures in medical cases (without surgical interventions). KDIGO severity grades 1-5 were considered, including dialysis costs. The costs generated by the chronic care of RRTs were not considered here. Hospitalization cost calculation was based on hospital controlling methodology including direct, indirect and overhead costs. For the national-level burden study, we analyzed the health claim records of all public and private hospitals for 2019.

Results: In 2019 a total number of 229 276 cases reported chronic kidney disease in Romania. The average hospital costs per patient episode was €917.1, with significantly higher costs in cases with complications or higher severity grades. The total hospitalization cost-related budget impact in 2019 was €210 million.

Conclusions: The high hospitalization costs of CKD (representing 2.6% of the NHIH budget, not considering the funds for sick leave) cause major impact on the national health payer`s budget. Preventive strategies, early diagnosis and management as well as health education measures could act as means of mitigation. Our results should warn the public health policy decision makers about the importance of this disease.

罗马尼亚慢性肾病的流行病学和住院费用。
背景:慢性肾脏疾病或慢性肾功能衰竭是一种进行性疾病,定义为肾脏结构或功能异常,持续时间超过3个月。据估计,全世界有超过10%的人口受到影响。慢性肾病的管理对低收入和中等收入国家的卫生系统来说是一个特别大的负担,它已被认为是一个主要的公共卫生问题。以前的研究报道罗马尼亚的年龄调整患病率为7.6%,但CKD产生的医院费用未知。本研究旨在衡量CKD的医院成本和一年的国家医疗预算影响,但不包括RRTs的慢性护理成本。方法:在这项回顾性研究中,我们回顾了2019年1月1日至2019年12月31日期间4所大学、3所县和5所市医院的电子健康记录,以计算因慢性肾脏疾病住院的相关费用。纳入标准定义为:ckd相关诊断代码或医疗病例中透析相关程序(无手术干预)。考虑KDIGO严重程度等级1-5,包括透析费用。这里没有考虑RRTs的慢性护理所产生的成本。住院费用的计算基于医院控制方法,包括直接、间接和间接费用。对于国家层面的负担研究,我们分析了2019年所有公立和私立医院的健康索赔记录。结果:2019年,罗马尼亚共报告了229 276例慢性肾脏疾病。每位患者发作的平均住院费用为917.1欧元,在出现并发症或严重程度较高的情况下,费用明显更高。2019年与住院费用相关的预算影响总额为2.1亿欧元。结论:CKD的高住院费用(占NHIH预算的2.6%,不考虑病假资金)对国家卫生付款人的预算造成重大影响。预防战略、早期诊断和管理以及健康教育措施可作为缓解措施。我们的研究结果应该提醒公共卫生政策决策者注意这种疾病的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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