Abstract: FR-PO685
Cost Consequence Analysis of a Remote Monitoring Program to Improve Clinical Practice of Automatized Peritoneal Dialysis in Colombia
Session Information
- Dialysis: Peritoneal Dialysis - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Ariza, Juan Guillermo, BAXTER, BOGOTA, Colombia
- Bunch, Alfonso, RTS, Bogota, Colombia
- Sanabria, Mauricio, RTS Baxter, Bogota, Colombia
- Rivera, Angela S., Baxter, Bogota, Colombia
- Vesga, Jasmin, RTS, Bogota, Colombia
Group or Team Name
- RTS Renal Therapy Services
Background
To estimate from the payer perspective, the cost and clinical consequences of a Remote Monitoring (RM) standardized program, supported in Claria Sharesource technology, to improve the clinical practice and control of incident patients in automatized peritoneal dialysis (APD) currently treated in the Renal Therapy Services (RTS) setting in Colombia.
Methods
A one year Markov analytic model, structured in five health states, was used to project costs and clinical outcomes from a cohort of 100 APD patients with and without RM. Real world outcomes required as model inputs such as rates of hospitalization, peritonitis, technique failure and mortality were estimated from retrospective patient level registries and RTS medical records. Renal care ambulatory costs were estimated from referent national tariffs. Inpatient care costs were obtained from administrative database in a referent health care provider. Model results were reported as the RM incremental effect in: overall direct costs, patient months in control, one year persistence in APD, hospitalization episodes, days of hospitalization, peritonitis episodes, technique failure episodes and death episodes. Both deterministic and probabilistic sensitivity analyses were done to analyze the effect of information uncertainty in the model results.
Results
In comparison with APD without RM, the implementation of a standardized RM program in 100 APD patients during one year resulted in: Overall savings USD $ 16,169; 73 additional patient months in control; 25 hospitalization episodes avoided; 243 hospitalization days avoided; 17 peritonitis episodes avoided; 7 technique failure episodes avoided; 7 death episodes avoided and 13 additional patients persisted in APD technique after one year. Deterministic sensitivity analysis: RM tariff, hospitalization rate and hospitalization episode costs were the most sensitive drivers of model results. Probabilistic sensitivity analysis: With 66% of chance, the RM standardized program was a cost-saving dominant intervention.
Conclusion
From the payer perspective, RM is a cost saving dominant alternative, improving patient time in control, burden of hospitalization, risk of complications, persistence in APD technique and mortality.
Funding
- Clinical Revenue Support