| Abstract: | The aims of this study were to compare the hospitalization utilization and expenses in patients with end-stage renal disease receiving hemodialysis (HD) and peritoneal dialysis (PD), and utilize in-depth interview to explore the problems that nephrologists may encounter in promoting PD.
By linking the hospitalization expenses inventory files, hospitalization medical orders inventory files, patient files, and institution files in the 2004 National Health Insurance Research Database owned by the National Health Research Institutes, we identified 14,851 patients and 221 patients that received HD and PD, respectively, continuously for more than 3 months. To compare their hospitalization costs, lengths of stay (LOS) due to complications, and total expenses for medical care. A total of 10 nephrologists with experiences in caring for patients on PD attended our interview. By using semiconstructive in-depth interview, we explored their thoughts of the ?Continuous Ambulatory Peritoneal Dialysis Promoting Program? and whether difficulties exist in executing the program.
The mean hospitalization frequency in patients on HD and PD was 1.78 and 1.14, while the mean LOS due to complications was 28.3 days and 26.4 days in the year 2004, respectively. The utilization of medical care was more frequent in patients on HD than those on PD. However, the mean expenses for medicine in hospitalization of patients on HD and PD were NTD 24,076 and NTD 45,317, and the mean medical care expenses were NTD 210,480 and NTD 234,786, respectively. The expenses consumed by patients on PD were more than those on HD.
All the interviewed nephrologists were willing to comply with the policy and promote PD, but the primary obstacle was the low willingness of the patients and their family. They suggested that in order to encourage the utilization rate of PD, the healthcare authorities should educate patients, their family and even the public, and enhance their acknowledgement of PD. |
