Home 2018 - Volume 18 (2) THE COST OF DIALYSIS IN MALAYSIA: HAEMODIALYSIS AND CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
THE COST OF DIALYSIS IN MALAYSIA: HAEMODIALYSIS AND CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PDF Print E-mail
Saturday, 01 December 2018 10:47

 

Naren Kumar Surendra1, Mohd Rizal Abdul Manaf1, Hooi Lai Seong2, Sunita Bavanandan3, Fariz Safhan Mohamad Nor4, Shahnaz Shah Firdaus Khan5, Ong Loke Meng6 and Abdul Halim Abdul Gafor7

1Department of Community Health, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia

Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000 Kuala Lumpur, MALAYSIA

2Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, MALAYSIA

3Hospital Kuala Lumpur, 50586 Jalan Pahang, Kuala Lumpur, MALAYSIA

4Hospital Tengku Ampuan Afzan, 25100 Kuantan Pahang, MALAYSIA

5Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200 Klang, Selangor, MALAYSIA

6Hospital Pulau Pinang, Residency Road, 10990 Penang, MALAYSIA

7Nephrology Unit, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000 Kuala Lumpur, MALAYSIA

Corresponding author: Mohd Rizal Abdul Manaf

Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

ABSTRACT

In Malaysia, dialysis-treated end stage renal disease (ESRD) patients have been increasing rapidly. Haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) use a disproportionately large amount of limited healthcare resources. This study aims to estimate the costs of HD and CAPD from the Ministry of Health (MOH) perspective. One year prospective multicentre study was conducted from October 2016 to September 2017 to assess direct medical costs of 90 HD patients and 73 CAPD patients from five large MOH dialysis centres. A mixed method of activity-based costing and step-down was used. The capital costs included land, building, medical equipment and furnishing. The recurrent costs included staff emoluments, facility utilities, patients’ medical costs and dialysis consumables. One-way sensitivity analysis was performed to investigate variability in the data. One hundred and forty-one patients (82%) completed the study comprising of 77 patients on HD and 64 patients on CAPD. Majority of the patients were between 46-65 years old (n=75, 53.2%). The most common aetiology of ESRD was diabetes mellitus (44.2% in HD and 48.4% in CAPD). Cost per patient per year was RM39,790 for HD and RM37,576 for CAPD. The main cost drivers were staff emoluments (37.6%) and dialysis consumables (70.5%) for HD and CAPD respectively. HD is highly sensitive towards all the variables analysed except for dialysis consumables. In CAPD, there are minimal sensitivities except for the 5% discount rate. Knowledge of the costs of modalities are useful in the context of planning for dialysis services and to optimise the number of kidney failure patients treated by dialysis within the MOH.

Keywords: Haemodialysis, continuous ambulatory peritoneal dialysis, end stage renal disease, cost, Malaysia.

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Last Updated on Saturday, 01 December 2018 10:52
 

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ISSN No : 1675-0306
e-ISSN No : 2590-3829

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