Background and objectives: The use of dialysis modalities for ESRD varies around the world. There is no consensus in literature regarding the most appropriate choice of dialysis method. The aim of this study was to analyze the initial modality for ESRD in Brazil and evaluate the factors determining patients' allocation to either hemodialysis (HD) or peritoneal dialysis (PD).Design, setting, participants, & measurements: A retrospective cohort study was performed using national administrative registries of all patients financed by the public system who began renal replacement therapy in 2000 in Brazil. Logistic regression analysis was used to investigate factors associated with the probability of receiving HD or PD at the start of treatment. Independent variables tested were age, sex, presence of diabetes, geographic region of residence, and health care supply indicators.Results: Of 11,563 patients analyzed, 88% started on HD and 12% started on PD. Patients were more likely to be assigned to HD if they were male (odds ratio: 1.44; 95% confidence interval: 1.23 to 1.68) and nondiabetic (odds ratio: 0.71; 95% confidence interval: 0.60 to 0.84). With regard to age, the youngest and the elderly showed lower probability of being in HD. In addition, the state of residence at the start of treatment was very important to explain initial modality allocation.Conclusions: Our findings suggest that patient allocation in Brazil is not random. The probability of allocation to HD or PD is highly associated with individual attributes and supply variables.
No abstract
En este informe se realiza un completo estudio descriptivo sobre los sistemas de copago y analizan algunas alternativas viables. Contiene: "Las alternativas para la revisión del sistema de copago sobre los medicamentos" de Jaune Puig-Junoy y "Sistema de copago no farmacéutico" de José Jesús Martín
ResumenEl artículo pretende ayudar a poner fin al desafortunado desencuentro entre las políticas (del medicamento) económico-industrial y sanitaria. Se analiza por qué ambos tipos de políticas pierden al ignorarse mutuamente teniendo en cuenta tanto la influencia de la regulación sobre la innovación como la conveniencia de que consigan mayores precios aquellas innovaciones que más contribuyan a un bie nestar en el cual la consideración del valor de la cantidad y calidad de los años de vida ganados juega un papel destacado. La financiación pública de los medicamentos expresa la disposición social a pagar de los sistemas nacionales de salud, no sólo en las decisiones de inclusión o exclusión en paquetes básicos sino también estableciendo la proporción de precio que se financia. De ahí la importancia que el artículo concede a cómo juzgar la efectividad incremental de las innovaciones en medicamentos y cómo ponerles precio. Los precios de referencia para equivalentes terapéuticos (como límite de la disposición a pagar) así como los copagos diferenciales basados en la relación coste-efectividad parecen ser adecuados para países que pretendan consolidar sus Estados de Bienestar al mismo tiempo que mejoran su productividad.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.