Comparing VA and Private Sector Healthcare Costs for End-stage Renal Disease
Bibliographic Data
| ID | 9105018 |
|---|---|
| Authors | Denise M Hynes (0000-0002-6436-7157, Edward Hines, Jr. VA Hospital, corresponding author), Kevin T Stroupe (0000-0001-9735-4929, Edward Hines, Jr. VA Hospital, corresponding author), Michael J Fischer (0009-0001-1713-9741, Jesse Brown VA Medical Center, corresponding author), Domenic J Reda (Edward Hines, Jr. VA Hospital, corresponding author), Willard G Manning (Edward Hines, Jr. VA Hospital), Willard Manning, Margaret M Browning (Edward Hines, Jr. VA Hospital, corresponding author), Zhiping Huo (0000-0002-5652-9726, Edward Hines, Jr. VA Hospital, corresponding author), Karen Saban, Karen L Saban (0000-0001-5767-5453, University of Illinois Chicago, corresponding author), James S Kaufman (0000-0002-6778-4167, Edward Hines, Jr. VA Hospital) |
| Year | 2012 |
| Volume | 50 |
| Issue | 2 |
| Pages | 161-170 |
| Publication date | 2012-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e31822dcf15 |
| PMID | 21945972 |
| OpenAlex | W2015396941 |
| Language | EN |
| References cited | 13 |
BACKGROUND: Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. METHODS: Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. RESULTS: The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; P<0.001), although levels were consistent with guidelines (Kt/V≥1.2). In adjusted analysis, the VA dialysis group had $36,431 higher costs than those in the private sector dialysis group (P<0.001). CONCLUSIONS: Continued research addressing costs and effectiveness of care across public and private sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD
Cohort · Dialysis · End stage renal disease · Health care · Hemodialysis · Intensive care medicine · Private sector · Public sector · Reimbursement · Veterans Affairs · Acute Kidney Injury Research · Chronic Kidney Disease and Diabetes · Dialysis and Renal Disease Management · Emergency Medicine · Internal Medicine · Medicine
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| Citation velocity | historical |
|---|---|
| Highly cited | No |