Chen, Winnie

Howard, Kirsten

Gorham, Gillian

Abeyaratne, Asanga

Zhao, Yuejen

Adegboye, Oyelola

Kangaharan, Nadarajah

Talukder, Mohammad Radwanur Rahman

Taylor, Sean

Cass, Alan

2024-07-09

The burden of chronic kidney disease (CKD) is high in the Northern Territory (NT), Australia. This study aims to describe the healthcare use and associated costs of people at risk of CKD (e.g. acute kidney injury, diabetes, hypertension, and cardiovascular disease) or living with CKD in the NT, from a healthcare funder perspective.We included a retrospective cohort of patients at risk of, or living with CKD, on 1 January 2017. Patients on kidney replacement therapy were excluded from the study. Data from the Territory Kidney Care database, encompassing patients from public hospitals and primary health care services across the NT was used to conduct costing. Annual healthcare costs, including hospital, primary health care, medication, and investigation costs were described over a one-year follow-up period. Factors associated with high total annual healthcare costs were identified with a cost prediction model.Among 37,398 patients included in this study, 23,419 had a risk factor for CKD while 13,979 had CKD (stages 1 to 5, not on kidney replacement therapy). The overall mean (± SD) age was 45 years (± 17), and a large proportion of the study cohort were First Nations people (68%). Common comorbidities in the overall cohort included diabetes (36%), hypertension (32%), and coronary artery disease (11%). Annual healthcare cost was lowest in those at risk of CKD (AUD$7,958 per person) and highest in those with CKD stage 5 (AUD$67,117 per person). Inpatient care contributed to the majority (76%) of all healthcare costs. Predictors of increased total annual healthcare cost included more advanced stages of CKD, and the presence of comorbidities. In CKD stage 5, the additional cost per person per year was + $53,634 (95%CI 32,769 to 89,482, p < 0.001) compared to people in the at risk group without CKD.The total healthcare costs in advanced stages of CKD is high, even when patients are not on dialysis. There remains a need for effective primary prevention and early intervention strategies targeting CKD and related chronic conditions.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia. winnie.chen@menzies.edu.au.

Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. winnie.chen@menzies.edu.au.

Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

NT Health, Darwin, Australia.

NT Health, Darwin, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

NT Health, Darwin, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

NT Health, Darwin, Australia.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, Australia.

BMC Health Serv Res . 2024 Jul 9;24(1):791. doi: 10.1186/s12913-024-11258-8.

1472-6963

https://pubmed.ncbi.nlm.nih.gov/38982437/?otool=iaurydwlib

https://hdl.handle.net/10137/13461

Chronic diseases

Chronic kidney disease

Costs

Health economics

Healthcare use

Indigenous health

Multimorbidity

Humans

Northern Territory

Male

Middle Aged

Female

Renal Insufficiency, Chronic

Retrospective Studies

Health Care Costs

Adult

Aged

Risk Factors

Patient Acceptance of Health Care

Costs and healthcare use of patients with chronic kidney disease in the Northern Territory, Australia.

Journal Article

Publication