OBJECTIVES

Increasing obesity, diabetes and hypertension in Australia, together with an ageing population, increased the number of people with end stage renal disease(ESRD). Many of these people need dialysis. Peritoneal dialysis(PD) is an option that allows patients to be treated in their own home. Patients on Automated PD(APD), who are monitored using remote patient management(RPM), have fewer hospitalisations over 12 months than patients who do not have RPM¹ (incident rate ratio 0.61[95% Confidence Interval(CI) 0.39 to 0.95]). This study aimed to estimate the reduction in hospital costs that could be achieved in Australia if patients on APD were remotely monitored.

METHODS

Total savings were estimated by multiplying the number of hospitalisations prevented by the cost of each hospitalisation, and then subtracting the cost of monitoring all patients. The cost of each hospitalisation was based on Australia’s national hospital costing study and the distribution of causes of hospitalisations reported by Sanabria et al. CIs were calculated using 100,000 simulations.

RESULTS

The estimated reduction in hospital episodes over a 12 month period for each 100 people who receive RPM while undergoing APD is 36(95% CI 25 to 47) with a potential savings of $AUD324,488 (95% CI$AUD183,185 to $AUD470,812). Assuming less complex admissions than indicated by the observed length of stay reported by Sanabria et al., would still achieve savings of $AUD85,533(95% CI$AUD23,876 to $AUD152,336) per 100 people undergoing APD.

CONCLUSIONS

There is an increasing number of people in Australia with ESRD, with many needing dialysis, and PD is often the preferred model of delivery in the home setting. Two-way remote management of APD patients can lead to better outcomes and a substantial reduction in costs to health services.

¹ Sanabria M, Buitrago G, Lindholm B, et al. Remote patient monitoring program in automated peritoneal dialysis: impact of hospitalisations. Peritoneal Dialysis International, Vol.39, pp.472–478