Public expenditure and budget for renal healthcare |
Goncalves et al.(2018)(19)
|
To estimate the cost of chronic kidney disease (CKD) and end-stage renal disease (ESRD) attributed to diabetes in Brazil, stratified by sex, race, skin color, and age. |
-
Diabetes was responsible for 22% of the total cost related to CKD and ESRD;
-
The largest share of costs attributable to CKD was hemodialysis (HD) and peritoneal dialysis (PD).
-
The economic burden of CKD may increase in future, posing severe implications for the financial sustainability of the Brazilian public health system.
|
Ismail et al. (2019)(20)
|
To quantify the economic burden of ESRD on the Malaysian healthcare system. |
-
The total annual public expenditure on ESRD grew by 94% over a 7-year period;
-
In 2010, spending on ESRD constituted 2.95% of total public sector health expenditure. In 2016, the proportion increased to 4.2%; with 6% of ESRD expenditures allocated to kidney transplantation and 94% to dialysis.
|
Afiatin et al. (2017)(21)
|
To assess the cost-effectiveness and budgetary impact of the HD-first policy compared to the PD-first in Indonesia. |
|
Ismail et al. (2020)(22)
|
To compare the economic burden of ESRD on the national health systems in countries with high prevalence according to the US Renal Data System (USRDS), including Malaysia. |
-
Expenditure on ESRD accounts for 0.91% to 7.1% of the total national health system expenditures in high-prevalence countries;
-
In Malaysia, the public sector paid for 70% of dialyses;
-
Expenditure on ESRD in Malaysia accounts for 4.2% of the total public health expenditure.
|
van der Tol et al. (2019)(23)
|
To compare global government reimbursements for dialysis costs. |
-
90% of the responding countries (n = 90) provided reimbursement for dialysis expenses;
-
In low- and middle-income countries, reimbursement of dialysis costs is insufficient to treat all patients with ESRD, and has a disproportionate effect on public health spending.
|
Tonelli et al. (2020a)(24)
|
To compare healthcare policies related to transnational dialysis between the US and Canada, focusing on payment, finance, regulation, and organization. |
-
Dialysis care in the US is primarily government-funded and provided predominantly by for-profit private providers;
-
Dialysis care in Canada is also government-funded and primarily provided via public facilities.
-
Differences in health policy areas are associated with considerable variations in clinical outcomes: mortality among patients undergoing dialysis is consistently lower in Canada than that in the US.
|
George et al. (2017)(25)
|
To assess the ability to screen for CKD in low- and middle-income countries. |
|
Infrastructure and human resources for renal healthcare |
Bello et al. (2017)(5)
|
To assess the current global state of kidney care. |
-
95%, 76%, and 75% of countries provided facilities for HD, PD, and transplantation, respectively;
-
In Africa, 94%, 45%, and 34% of countries offered facilities for HD, PD, and transplantation, respectively;
-
Tests for monitoring CKD in primary care were consistently available in 18% and 8% of countries;
-
The number of nephrologists was variable and low (<10 per million inhabitants) in Africa, Middle East, South Asia, Oceania, and Southeast Asia.
|
Hippen et al.(2018)(26)
|
To propose a model for integrating general nephrology practices, transplant centers, and dialysis providers to offer care for patients across the entire spectrum of kidney disease. |
-
The expanded Comprehensive ESRD Care (CEC) model integrates nephrology practices, dialysis providers, and transplant centers, enabling the development of novel strategies to care for all patients with kidney diseases.
|
Kaze et al. (2018)(27)
|
To assess the prevalence of CKD in African populations and examine local registration, screening, and care models. |
|
Jardine et al.(2020)(28)
|
To assess the status of CKD care and treatment in South Africa. |
|
Lunney et al. (2019)(29)
|
To compare Canada’s ability to provide renal healthcare with that of other countries with similar economic situation. |
-
Most Organization for Economic Co-operation and Development (OECD) countries provide government-funded renal healthcare;
-
Canada has a public fund for treatment and a mixed public-private fund for medications;
-
Healthcare capacity is not homogeneous across provinces.
|
Flood et al. (2020)(30)
|
To evaluate healthcare professionals’ perceptions of the quality of renal care provided at a public nephrology center in Guatemala. |
-
The primary challenge is providing high-quality care due to resource constraints;
-
Practitioners reported substantial emotional challenges related to high patient volume and difficult decisions regarding resource allocation.
|
Delatorre et al. (2021)(31)
|
To investigate the knowledge and attitudes of primary care physicians regarding the care of patients with CKD in Brazil. |
|
Riaz et al. (2021)(32)
|
To assess the global workforce capacity for renal failure care. |
-
The workforce varies based on the country’s income level;
-
The global density of nephrologists is 10.0 pmp;
-
High-income countries have an average of 23.2 nephrologists pmp, whereas low-income countries provide only 0.2 nephrologists pmp.
|
Public assistance |
Bello et al. (2017)(5)
|
To assess the current global status of kidney care. |
-
HD, PD, and transplant services were publicly funded and free in 42%, 51%, and 49% of countries, respectively.
|
van der Tol et al. (2019)(23)
|
Compare global government reimbursements for dialysis costs. |
|
Jardine et al. (2020)(28)
|
To assess CKD care and treatment in South Africa. |
|
Rojahn et al. (2016)(33)
|
To identify public policies for remote monitoring (RM) in the United Kingdom, Germany, Italy, and Spain. |
-
Policies on RM and/or telemedicine addressing non-communicable diseases (NCDs) have been identified and are well-received in all countries surveyed;
-
Pilot projects (primarily on diabetes, chronic obstructive pulmonary disease, and/or heart failure) were established or in planning stages in most countries.
|
Santos Junior et al.(2017)(34)
|
To describe the prevalence of patients with ESRD on publicly funded dialysis in Brazil. |
-
From 2008 to 2013, a 25% increase in the absolute number of HD sessions was noted;
-
From 2008 to 2013, the kidney transplant rate increased from 35.2 to 41.6 transplants per year pmp.
-
In 2013, HD was the most frequent therapeutic modality (87.1%), followed by PD (9.2%) and continuous outpatient treatment (3.7%).
|
Norouzi et al. (2020)(35)
|
To investigate the effect of including new medications in the reimbursement package for patients with ESRD in US dialysis institutions. |
|
Chuengsaman et al. (2017)(36)
|
To assess key policy development and implementation strategies, such as home PD in Thailand. |
|
Kanjanabuch et al.(2020)(37)
|
To assess the impact of the PD first policy and reimbursement schemes on dialysis treatment in Thailand. |
-
In 2008, the Thai government launched the PD First policy, providing Thai citizens with universal health coverage for dialysis;
-
After the implementation of the “PD First” policy, the number of patients in dialysis and dialysis centers increased exponentially.
|