Análisis del impacto presupuestario de ampliar la oferta del Servicio de Hemodiálisis de la Caja Costarricense de Seguro Social, para la población con enfermedad renal crónica

Azofeifa Chacón, Carlos

Análisis del impacto presupuestario de ampliar la oferta del Servicio de Hemodiálisis de la Caja Costarricense de Seguro Social, para la población con enfermedad renal crónica

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Azofeifa Chacón, C. Análisis del impacto presupuestario de ampliar la oferta del Servicio de Hemodiálisis de la Caja Costarricense de Seguro Social, para la población con enfermedad renal crónica. 2021. handle: http://hdl.handle.net/10230/48969

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Abstract

Objective: To estimate the budgetary impact of expanding the healthcare of people with terminal chronic kidney disease (CKD) by hemodialysis treatment, from the Caja Costarricense de Seguro Social perspective, within five years. Methods: A budget impact analysis model was performed from the current cost structure per hemodialysis treatment session in the Caja Costarricense de Seguro Social (CCSS). Data are from the infrastructure facilities, equipment, and maintenance costs from Hospital de la Anexión, Liberia; other direct and indirect costs remain fixed. The target population was estimated based on the percentage of global prevalence (1), assuming census projection on the total population for Costa Rica (2). Patients currently on continuous dialysis and those with kidney transplant on functional status (alive) were subtracted. It was assumed that 20% of all patients require hemodialysis treatment. An increasing diffusion rate of 20% per year is considered. An institutional ratio of 4.5 patients per hemodialysis machine and three weekly sessions is assumed. Costs were converted to 2021 U.S. dollars using exchange rates for currency conversion. A discount rate of 8.31% applies. An external provider's cost per hemodialysis treatment session is used as an alternative analysis to assess the opportunity cost of resources. Results: After five years, when considering the CCSS cost scenario, the total discounted cost estimated is US$ 15,973,978.3, while the private alternative represents US$ 21,285,015.4. Discussion: The treatment cost for people with CKD-5 is lower when expanding the healthcare facilities than with a third party contract for private healthcare. The authorities should analyze in-depth the sensitized variables affecting the model to incorporate strategies for reducing future to achieve resource efficiency.