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Simulation model of renal replacement therapy: predicting future demand in England
Paul Roderick1, Ruth Davies, Chris Jones
1Health Care Research Unit, Southampton University, UK. pjr@soton.ac.uk
Summary
Renal replacement therapy demand in England is projected to grow significantly by 2010, driven by acceptance rates and dialysis survival, particularly among the elderly. A steady state for this increasing demand is not expected for at least 25 years.
Area of Science:
- Nephrology
- Public Health
- Health Services Research
Background:
- The demand for renal replacement therapy (RRT) in England is increasing.
- Accurate demand prediction is crucial for effective RRT service planning.
Purpose of the Study:
- To predict the future demand for RRT in England up to 2010.
- To analyze the impact of key factors like acceptance rates, transplant supply, and patient survival on RRT demand.
Main Methods:
- A discrete event simulation model was developed to estimate future RRT demand.
- The model incorporated current prevalence, projected acceptance and survival rates, and demographic data.
- Data sources included the UK Renal Registry and UK Transplant.
Main Results:
- RRT prevalence in England is predicted to rise from 30,000 in 2000 to 42,000-51,000 by 2010 (4.5-6% annual growth).
- Transplant supply changes have a minor effect on overall numbers but impact graft function rates.
- Acceptance rates and dialysis survival are the primary drivers of future patient numbers, especially in the elderly.
Conclusions:
- The RRT population in England is projected to grow substantially by 2010, nearing 1000 people per million population.
- This growth is particularly pronounced in the elderly and those on hemodialysis (HD).
- A steady state for RRT demand is not anticipated for at least 25 years.