ABSTRACT
The cost of kidney transplantation (KT) and its follow-up care greatly exceeds the mean annual family income. Governmental support during the post-transplant period is needed. This study aimed to identify the drivers of cost during the 1st year after KT. The records of 129 adult Filipino KT recipients over 2 years in a single center were reviewed to determine the total cost for the 1st year after KT, such as diagnostics, medications, supplies, and professional fees. Univariate and multivariate analyses were carried out to determine the economic impact of the baseline characteristics, comorbidities, and events after KT. The direct costs of care were significantly higher among patients aged >40 years (P = 0.009), those with diabetic kidney disease as the primary renal disease (P <0.0001), and those with a high Charlson comorbidity index (P = 0.001). Multivariate regression analysis showed that patients with diabetes mellitus paid US$ 6813.6 more, and those hospitalized for any infection spent US$ 3877.4 more than those without comorbid conditions or complications. The results showed that diabetes mellitus and hospitalization for any infection significantly impacted the cost of follow-up care. Health-care policies that can aid patients after KT are needed to minimize expenditures and avoid complications.
Subject(s)
Health Care Costs , Kidney Transplantation , Humans , Kidney Transplantation/economics , Retrospective Studies , Male , Female , Adult , Middle Aged , Time Factors , Philippines/epidemiology , Comorbidity , Treatment Outcome , Risk Factors , Young AdultSubject(s)
Kidney Diseases/diagnosis , Mass Screening , Asia/epidemiology , Asian People , Benchmarking , Chronic Disease , Early Diagnosis , Humans , Kidney Diseases/ethnology , Kidney Diseases/etiology , Mass Screening/methods , Predictive Value of Tests , Prognosis , Risk Assessment , Risk FactorsABSTRACT
PURPOSE OF REVIEW: The purpose of this review is to discuss the recent events and experiences in the Philippines related to compensated kidney donation. RECENT FINDINGS: Between 2002 and 2008, the Philippine government, through the Department of Health, administered a program called the Philippine Organ Donation Program that allowed prospective kidney providers to sign up, be allocated to prospective recipients and receive gratuities for their kidney. Transplant tourism flourished during this period because of rampant disregard for the regulation limiting foreign recipients to 10% of total kidney transplants. There is evidence of inadequate donor care. Efforts to curb the problem included a ban on foreigners coming to the Philippines to have kidney transplants with Filipinos as donors as well as strengthening of the implementing rules and regulations of both the antihuman trafficking law and the organ donation law that allowed donation after brain death. SUMMARY: The experience in the Philippines mirrored those in India and Pakistan where paid donors reported poor outcomes. An effective national kidney disease prevention program and the deceased donor program for transplantation should be aggressively promoted. Legislation against transplant commercialism is needed.
