Table 2 Summary list of assumptions on the model structure, transition and parameters
Model Structure | |
Health Status Transitions within one-year cycle | |
• There are five principal health status: ‘PD’, ‘hospital-based HD’, ‘home-based HD’, ‘transplant and post-transplant’, and ‘death’ | |
• ESRD patients commencing home-based HD are prohibited from switching treatment modality to PD as there were no observed data / documented data from literature / data source | |
• Post-transplanted patients are prohibited from modality switching to any forms of dialysis | |
• Renal transplantation rates are identical for ESRD patients on any forms of dialysis. | |
• Annual mortality rates depend on current treatment modality, but independent of previous or initial treatment modalities if the change in treatment modality occur | |
Model Parameters | |
Healthcare resource use and cost | |
• Costs associated with each treatment modality (PD, hospital-based HD, home-based HD, transplant) are divided into initial year (or first year) and subsequent years (retaining the same treatment modality for 2 years or above) | |
• Cost of pre-dialysis surgery accrues when patient initiates new dialysis | |
• Cost of the surgery related to the removal of catheter / vascular access accrues when patient switches to another dialysis or undergoes renal transplantation | |
• No removal of vascular access when patient switches from hospital-based HD to home-based HD and vice versa | |
• No removal of catheter / vascular access when patient switches from any treatment modality to death | |
• Dialysis complication is reflected in the number of outpatient visits, emergency visits, and the number of hospitalization days | |
• Costs associated with renal transplantation and pre-dialysis surgery refer to the list of private charges to cost item in Hospital Authority. The charge covers surgeon fee, administration of anaesthetics, medicines used in operation, and operating theatre expenses | |
• Cost of chronic haemodialysis, rather than acute haemodialys, is charged to each session of hospital-based HD | |
• Unit costs of cadaveric and living-related transplantations, and transplantations performed outside HK are the same | |
Health utility | |
• Utility decrements depends on the current treatment modality. Utility decrements due to age, duration of ESRD, and duration of dialysis initiation are not taken into account |