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Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS)

Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS)
Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS)

Background: Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. Aim: Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease. Design: Health service use was recorded up to 12 months after making the decision to receive conservative management. Mean costs were calculated for each 3-month time period. The annual cost was calculated in two ways: by using only patients with complete cost data and by using all available data weighted by the number of patients at each time point. Setting: In total, 42 patients who opted for conservative management over dialysis were recruited. Results: Mean costs were £1622 (0–3 months), £1008 (3–6 months), £554 (6–9 months) and £2626 (9–12 months). Mean annual cost based on complete data (n = 8) was £5511, and the weighted mean annual cost was £5620. Conclusion: The importance of this study is twofold. First, it provides substantive new information for health and social care planning of conservative management by demonstrating where demand exists for services, in both the United Kingdom and other countries with a comparable health service structure. Second, methodologically, it indicates that it is feasible to collect service use data directly from this patient population.

Chronic kidney disease, conservative management, costs, economics
0269-2163
1401-1409
Phair, Glenn
54531656-e473-42a2-8f01-9803640708da
Agus, Ashley
4a90a841-1b68-40c9-b1be-99421264b1f5
Normand, Charles
c71e3cc5-c270-4cb3-9581-19e7b6540840
Brazil, Kevin
75d72263-0eb1-4b79-99a6-04198b3b549c
Burns, Aine
4609b293-168c-4d12-8a0c-88aa65c1901f
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Maxwell, Alexander P.
1f5de478-59ba-4954-9ccf-28a15fe8dd8f
Thompson, Colin
f8585002-df21-49f5-ae97-e7fd968a0b23
Yaqoob, Magdi
8120273f-99a7-4818-a576-75a79e165541
Noble, Helen
65485329-4bed-4f9b-96c1-26e7f91e531f
Phair, Glenn
54531656-e473-42a2-8f01-9803640708da
Agus, Ashley
4a90a841-1b68-40c9-b1be-99421264b1f5
Normand, Charles
c71e3cc5-c270-4cb3-9581-19e7b6540840
Brazil, Kevin
75d72263-0eb1-4b79-99a6-04198b3b549c
Burns, Aine
4609b293-168c-4d12-8a0c-88aa65c1901f
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Maxwell, Alexander P.
1f5de478-59ba-4954-9ccf-28a15fe8dd8f
Thompson, Colin
f8585002-df21-49f5-ae97-e7fd968a0b23
Yaqoob, Magdi
8120273f-99a7-4818-a576-75a79e165541
Noble, Helen
65485329-4bed-4f9b-96c1-26e7f91e531f

Phair, Glenn, Agus, Ashley, Normand, Charles, Brazil, Kevin, Burns, Aine, Roderick, Paul, Maxwell, Alexander P., Thompson, Colin, Yaqoob, Magdi and Noble, Helen (2018) Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS). Palliative Medicine, 32 (8), 1401-1409. (doi:10.1177/0269216318775247).

Record type: Article

Abstract

Background: Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. Aim: Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease. Design: Health service use was recorded up to 12 months after making the decision to receive conservative management. Mean costs were calculated for each 3-month time period. The annual cost was calculated in two ways: by using only patients with complete cost data and by using all available data weighted by the number of patients at each time point. Setting: In total, 42 patients who opted for conservative management over dialysis were recruited. Results: Mean costs were £1622 (0–3 months), £1008 (3–6 months), £554 (6–9 months) and £2626 (9–12 months). Mean annual cost based on complete data (n = 8) was £5511, and the weighted mean annual cost was £5620. Conclusion: The importance of this study is twofold. First, it provides substantive new information for health and social care planning of conservative management by demonstrating where demand exists for services, in both the United Kingdom and other countries with a comparable health service structure. Second, methodologically, it indicates that it is feasible to collect service use data directly from this patient population.

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More information

Accepted/In Press date: 1 May 2018
e-pub ahead of print date: 16 May 2018
Published date: September 2018
Keywords: Chronic kidney disease, conservative management, costs, economics

Identifiers

Local EPrints ID: 424854
URI: http://eprints.soton.ac.uk/id/eprint/424854
ISSN: 0269-2163
PURE UUID: 8a947ebe-30b6-4f0d-acf5-8db39bc315a8
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 05 Oct 2018 11:50
Last modified: 27 Jan 2020 13:35

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