Dialysis Costing Study

NSW Health, 2009

The Statewide Services Development Branch of the NSW Health Department engaged Health Policy Analysis to undertake a comprehensive and detailed study of the costs of dialysis by modality, and compile costs per patient per year, identify differences between rural and metropolitan Area Health Services and develop a funding model for home based dialysis modalities.

The study involved an extensive literature review, extensive consultation with nephrologist, dialysis nurse unit managers and other stakeholders, a data collection process involving all public sector dialysis units across NSW, management of a survey of the population of patients on dialysis in NSW focussing on out of pocket expenses, extensive analysis of data including other data sources such as the ANZ Data registry. The survey of patient required approval from a lead research ethics committee, and 26 site specific approvals.

The final report is the first Australian report to fully document the full extent of out of pocket expenses faced by dialysis patients. It is also one of the largest dialysis costing studies undertaken internationally. The report provided estimates of the costs of dialysis service provision, by dialysis modality for urban and rural sites. It also provided estimates of associated costs, including specialist, general practice and allied health consultations, and hospital admissions (in addition to those related specifically to dialysis provision).

Preliminary results were presented to a workshop of service providers including consumers, senior nephrologists, nurse unit managers, allied health staff and health service managers. The workshop provided an opportunity to validate results, explore interpretations and identify further issues for investigations. The workshop was well received and has contributed to the acceptance of the study’s results amongst senior clinicians in NSW.

NSW Health will be using the results of the study for planning and funding of dialysis services.