Cost analysis of dialysis treatment methods

Kidney failure is the last stage of chronic kidney disease. After this stage, it is unlikely for the patient to survive without dialysis or kidney transplantation. For this reason, the need for renal replacement therapy methods is increasing day by day for patients with chronic renal failure, and these treatment methods have an important place in the patient's life. This study was carried out to analyze the cost of hospital hemodialysis, home hemodialysis and peritoneal dialysis, which are among the renal replacement therapy methods, and to determine the least costly method with the cost data obtained. In the study, a detailed cost analysis was carried out by examining all cost items of the existing hospital for cost analysis and using the actual-full-order cost method, one of the cost distribution methods. Distribution tables were created with the distributions, which were defined as the first, second and third distribution, and which were realized in three separate stages. Expense distribution tables are arranged in the "expense types - expense locations" systematic of the Uniform Accounting System (TDMS). With the second distribution, the unit and the total costs of the units were determined and compared with the revenues; With the third distribution, the unit session costs were calculated and compared with the SGK repayment amounts. Since the basis for distributions is to determine the cost of service production, the expenses accumulated in the period expense centers are not distributed. The total amount of the Dialysis Unit from the work done is 3.012.465,99 TL. Of this system, 2.689.037,68 TL is hospital hemodialysis, 227.749,67 TL is home hemodialysis and 95.678,64 TL is peritoneal dialysis. First class first class sophomore justice 94% of the total budget. The total income of the dialysis unit in the six-month period is 1,877,454.00 TL. Of the total income, 1.662.440.00 TL is hospital hemodialysis, 186.530.00 TL is home hemodialysis and 7.784.00 TL is peritoneal dialysis. In this study carried out in Muğla Training and Research Hospital Dialysis Unit, it was calculated that hospital hemodialysis was 1,026,597.68 TL in total, 142,03 TL per session, and home hemodialysis was 20,519,67 TL in total. However, home hemodialysis patients consist of education and control patients. Training patients perform their education only once and in a very short time (at least three months) during their years of dialysis. After this training process, patients perform their own treatment at home. If the expenses of home hemodialysis patients during the education process are subtracted because they receive dialysis without any cost to the hospital, and the process that they come to the hospital for control, it can be said that the hospital earns 32.68 TL per session. It was calculated that the total income of the hospital, peritoneal dialysis training and control patients was below 82,557.86 TL. If we look at the cost per session of peritoneal dialysis training and control patients together, it was found to be 593.94 TL. Peritoneal dialysis training patient cost was 5004.98 TL per session, and control patient cost was 560.43 TL per session. Peritoneal dialysis SSI reimbursement education patients are billed per service and SGK repayments are made on the basis of the patient's invoice. For peritoneal dialysis control patients, SGK is 56 TL per case and SGK reimburses this amount. In this case, peritoneal dialysis training patients are 555.80 TL per patient; income covers expenses; Peritoneal dialysis control patients are 504.43 TL per patient, and considering that a patient receives dialysis four times a day on average, it is calculated that the income is below 126.11 TL per session. As a result, the price per case of SSI should be increased for hospital hemodialysis, one of the dialysis treatment methods. The cost of home hemodialysis is less costly for health institutions compared to other treatment methods. For this reason, patients who need to start dialysis or receive dialysis treatment should be referred to home hemodialysis if deemed appropriate, and home hemodialysis incentives should be started in general.