Impact of initial dialysis modality and modality switches on Medicare expenditures of end-stage renal disease patients

摘要: Impact of initial dialysis modality and switches on Medicare expenditures end-stage renal disease patients. Background The number (ESRD) enrollees have increased dramatically. Pathways associated in ESRD treatment need to be examined potentially improve the efficiency care. Methods This study examines impact choice subsequent expenditure a 3-year period. Dialysis Morbidity Mortality Study Wave 2 data by United States Renal Data System (USRDS) is used along with USRDS Core CD claims data. Results A total 3423 incident patients (approximately equal peritoneal hemodialysis) were included analysis. Unadjusted average annual (in 2004 dollars) for as first was $53,277 (95% CI $50,626-$55,927), $72,189 $67,513-$76,865) hemodialysis. Compared "hemodialysis, no switch" subgroup, "peritoneal dialysis, had significantly lower ($44,111 vs. $72,185) (P Conclusion Initial (peritoneal or significant implications treatments.