ArticleApplied health economics and health policy2025
The Cost-Effectiveness of Initiating Patients on Home Dialysis Compared with In-Centre Haemodialysis.
Article in Applied health economics and health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed.
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Authors and funding
10 authors.
Funding
Abstract
objectivesKidney failure can be treated at home with peritoneal dialysis or home haemodialysis. The combination of reduced staffing, transport and overhead costs and improved quality of life through treatment at home could make initiating dialysis at home highly cost-effective. The primary objective is to estimate the cost-effectiveness of initiating patients on home dialysis therapy (HDT) compared with in-centre haemodialysis (ICHD). The secondary objective is to determine the upper limit of net benefit from removing potential service barriers within dialysis centres that hinder the adoption of HDT.
methodA multistate model using UK Renal Registry data combined with national survey data was developed to estimate patient and dialysis centre influences on dialysis treatment modality changes and the duration in each modality. These are used as inputs to a microsimulation estimating the lifetime quality-adjusted life years (QALYs) and UK National Health Service (NHS) costs incurred for patients, the cost-effectiveness of HDT compared with ICHD and the differences in costs and health outcomes associated with removing specific barriers to HDT uptake.
resultsCommencing HDT compared with ICHD resulted in 0.30 additional QALYs and saved Great British (GB) £15,272. HDT has an 82% probability of being cost-effective. Implementing quality-improvement initiatives and alleviating stresses on staff capacity are identified as influential in the multistate model. Addressing these led to QALY gains of 0.22 and 0.08 and cost increases of GB £10,059 and GB £5127 from an increase of life years lived of 0.54 and 0.22, respectively.
conclusionsInitiating patients on HDT is cost-effective compared with ICHD. Alleviating stresses on staff capacity and implementing quality improvement initiatives in dialysis centres leads to health improvements, although these changes are not cost-effective owing to the associated increase in healthcare costs.
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