探索美国脏透析成本:一个范围审查
Fiona Stewart1, Kristin Kistler1, Yuxian Du2
1Cencora, Biopharma Services, Conshohocken, Pennsylvania, USA.
Journal of medical economics
|April 12, 2024
概括
高昂的透析费用给美国经济带来负担. 减少末期病 (ESRD) 的进展和优化资源使用,比如扩大腹腔透析 (PD),可以降低医疗保险和私人纳税人的支出.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 末期病 (ESRD) 的患病率在美国正在上升,由于透析治疗成本高,造成了严重的经济负担.
- 透析费用是ESRD受益人医疗保险支出的主要部分.
研究的目的:
- 审查现实数据,并确定透析治疗的关键成本驱动因素.
- 探索减少整体透析成本的潜在策略.
主要方法:
- 对MEDLINE,Embase和灰色文学 (2016-2023) 进行了全面的文献搜索.
- 确定和综合了报告美国成年患者直接透析成本的证据.
主要成果:
- 医疗保险在2020年花费了29亿美元用于血液透析和28亿美元用于腹腔透析 (PD),透析成本占医疗保险ESRD总支出的80%左右.
- 与医疗保险 (3364美元/月) 相比,私人保险公司的透析费用 (每月10149美元) 比医疗保险 (每月3364美元) 高.
- 高风险群体 (如2型糖尿病,C型肝炎) 的成本较高,血管接入占成本的重要组成部分.
结论:
- 防止或延迟ESRD的进展为付款人提供了巨大的成本节约,特别是在高风险人群中.
- 高效的资源利用,包括具有成本效益的药物和扩大PD访问,可以改善结果并降低总体支出.
- 解决高风险患者群体的成本驱动因素对于管理透析支出至关重要.
关键词:
透析是通过透析进行的.在这里,我们可以看到H H H H H H.H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H5 H3 H5 H5 H5 H3 H4 H5 H5 H5 H5 H3 H5 H4 H5 H5 H6 H7 H8 H8 H8 H8 H8 H8 H8 H8 H9 在线阅读更多H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51 H51我已经开始了,我已经开始了.第111章 这是一件好事一千一百一十,就是这样.一百一十一章 一百一十一章第113章 这是什么?费用 费用 费用 费用 费用 费用 费用 费用最终阶段的脏疾病.血液透析是血液透析的方法之一.叙事审查 叙事审查腹膜透析是指腹膜透析.美国的美国.
相关概念视频
01:27Dialysis
307
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
307
01:15Renal Drug Excretion: Overview
152
As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
152
01:11Renal Failure: Dose Adjustments
88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
01:45Kidney Structure
69.6K
The kidneys are two large bean-shaped organs located in the upper abdomen. They filter the blood several times a day to remove toxins and rebalance water and electrolytes of the circulatory system via the renal veins. The kidneys receive blood directly from the heart via the renal arteries. These arteries enter the kidney at the hilum, the concave surface of the bean, where they branch and divide into smaller vessels and capillaries.
69.6K
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
134
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
134