HOME PERITONEAL DIALYSIS TRENDS AFTER POLICY CHANGES IN JAPAN: SERIAL CROSS SECTIONAL ANALYSIS
Author(s)
Yuexiang Ji, BSc, MSc candidate1, Takehiro Ishida, DrPH2, Satoshi Yamaguchi, MSc1, Shu Sasaki, BSN candidate1, Amy Crawley, BA candidate1, Ayaka Mukuta, BA candidate1, Suzuho Matsuda, BA candidate1, SHIORI TOSHIMITSU, BA1, Tomoya Ookado, MBA1, Yui Higa, BA candidate1.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
1Glocal Innovator & Future Talent Society, Tokyo, Japan, 2Teikyo University Graduate School of Public Health, Tokyo, Japan.
OBJECTIVES: Home peritoneal dialysis (HPD) can support quality of life and cost-efficient chronic kidney disease care, but home dialysis remains underused in Japan. In 2023, HPD accounted for only 2.4% of dialysis patients. To promote home-based dialysis, Japan introduced reimbursement reforms including a 1,150 JPY (7.93 USD) incentive for home peritoneal dialysis management and updated clinical guidelines.
METHODS: A nationwide serial cross-sectional study used publicly available aggregated claims data from FY2021 to FY2023. The outcome was annual HPD instruction/management fee claims per 100,000 population; Year-over-year changes, age-sex stratified rates, and prefecture-level paired t-tests across 47 prefectures were calculated.
RESULTS: National HPD claims per 100,000 population increased from 91.3 in FY2021 to 92.4 in FY2022 and 98.4 in FY2023. The FY2022-to-FY2023 increase was 6.6%. HPD increased in all age-sex strata: males aged <65 years, 78.3 to 83.9 (7.2%); males aged ≥65 years, 260.5 to 273.5 (5.0%); females aged <65 years, 42.6 to 45.4 (6.6%); and females aged ≥65 years, 100.4 to 108.2 (7.7%). The mean prefecture-level HPD rate increased from 98.5 (95% CI, 86.5 to 110.5) to 105.5 (95% CI, 91.9 to 119.1) per 100,000 population. The mean increase was 7.0 (95% CI, 3.9 to 10.2), and a statistically significant increase was observed across prefectures (p<0.01).
CONCLUSIONS: HPD claims increased nationally from FY2022 to FY2023 across demographic strata and prefectures following reimbursement and guideline changes. Given the cost-efficiency advantages of HPD, continued monitoring of utilization trends following reimbursement reform is warranted from a health economics perspective.
METHODS: A nationwide serial cross-sectional study used publicly available aggregated claims data from FY2021 to FY2023. The outcome was annual HPD instruction/management fee claims per 100,000 population; Year-over-year changes, age-sex stratified rates, and prefecture-level paired t-tests across 47 prefectures were calculated.
RESULTS: National HPD claims per 100,000 population increased from 91.3 in FY2021 to 92.4 in FY2022 and 98.4 in FY2023. The FY2022-to-FY2023 increase was 6.6%. HPD increased in all age-sex strata: males aged <65 years, 78.3 to 83.9 (7.2%); males aged ≥65 years, 260.5 to 273.5 (5.0%); females aged <65 years, 42.6 to 45.4 (6.6%); and females aged ≥65 years, 100.4 to 108.2 (7.7%). The mean prefecture-level HPD rate increased from 98.5 (95% CI, 86.5 to 110.5) to 105.5 (95% CI, 91.9 to 119.1) per 100,000 population. The mean increase was 7.0 (95% CI, 3.9 to 10.2), and a statistically significant increase was observed across prefectures (p<0.01).
CONCLUSIONS: HPD claims increased nationally from FY2022 to FY2023 across demographic strata and prefectures following reimbursement and guideline changes. Given the cost-efficiency advantages of HPD, continued monitoring of utilization trends following reimbursement reform is warranted from a health economics perspective.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HPR9
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
SDC: Urinary/Kidney Disorders