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Kidney Week

Abstract: FR-PO460

Assessing the Value of an Integrated Multidisciplinary Patient Centric Program for Patients in Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Martinez Vaquera, Shaira, Diaverum Espana, Madrid, Spain
  • Molina, Sonia Caparros, Diaverum Espana, Madrid, Spain
  • Martinez Sanchez, Teresa, Diaverum Espana, Madrid, Spain
  • Sorribes López, Maria Paz, Diaverum Espana, Madrid, Spain
  • Fraile, Ivan, Diaverum Espana, Madrid, Spain
  • de Leon-Ponce de Leon, Ignacio, Diaverum Espana, Madrid, Spain
  • Martinez Perez, Oscar, Axentiva Solutions SL, Barcelona, Spain
  • Diaz-Cuervo, Helena, Axentiva Solutions SL, Barcelona, Spain
  • Cuervo, Jesús, Axentiva Solutions SL, Barcelona, Spain
  • Ordoñez Martí Aguilar, Jose Maria, Diaverum Espana, Madrid, Spain
  • Macario, Fernando Jose Gordinho Rocha M, Diaverum Renal Services Group, Lund, Scania, Sweden

Group or Team Name

  • Diaverum Catalonia PCC Team.
Background

Chronic kidney disease (CKD) constitutes a public health concern due to its notable morbidity&mortality and associated costs. The Patient Care Coordination program (PCC) provides comprehensive and personalized care to hemodialysis (HD) patients. This study evaluated the cost-effectiveness of PCC compared to standard of care (SoC).

Methods

The study included patients in 9 HD clinics (5 PCC, 4 SoC) in Catalonia, Spain, in 2020-2021. A comparative effectiveness evaluation was conducted to compare change in Individual Patient Performance Score (IPPS, score 0-100, evaluates parameters such as vascular access, adequacy of HD, anemia, mineral bone disease, arterial hypertension, nutrition/hydration status) and number of hospitalizations of PCC patients vs SoC during the first year in the program. Instrumental variables (IV) regression analysis was performed to address potential confounding; number of interactions with program specialists was a valid IV to estimate degree of PCC use. An incremental cost-effectiveness analysis (iCEA) through microsimulation was performed using the effectiveness data from the previous step, population data from the renal patient registry of Catalonia, and the cost of hospitalizations obtained from the Public Health System.

Results

127 patients in PCC and 363 patients in SoC were included. The degree of PCC use had a positive impact on IPPS variation during the first year of the program (p= 0.012). In the iCEA the PCC program resulted in a mean gain of 3.4 additional IPPS points, a reduction of 0.2 hospitalizations per patient, and reduced mean costs of €1,265 per patient in the first year compared to SoC, resulting to be a dominant alternative (Figure 1).

Conclusion

Use of PCC resulted in positive impact in outcomes and reduced costs compared to SoC for HD patients. The PCC program represents thus a dominant alternative, with greater effectiveness and total cost savings that could sum up to €5.5 million per year in the region due to reduced hospitalizations. The findings underscore the relevance of comprehensive and personalized care in addressing the challenges of CKD and optimizing healthcare resource allocation.

Funding

  • Private Foundation Support