OBJECTIVE

To assess the compulsory health insurance system costs for the management of patients with chronic kidney disease (CKD) in different medical facilities and to identify the factors affecting these costs.

MATERIAL AND METHODS

Depersonalized data on costs were extracted from the invoices submitted by hospitals of the Moscow region and paid by insurance company. Analysis included patients with CKD (N18.1—N18.5) listed in the registry as the main diagnosis. All patients received day care, inpatient and outpatient care between January 1, 2019 and December 31, 2019.

RESULTS

Mean annual costs of compulsory health insurance system per a patient with CKD were 1.289.0, 535.947.4 and 75.967.8 rubles for outpatient treatment, day and inpatient care, respectively. Costs of outpatient and in-hospital treatment significantly increased in the later stages of disease (variance analysis; p<0.05). Mild influence of age on the treatment cost was revealed for outpatient care (ANCOVA; 0.3%, p=0.009). Day medical care consisted of dialysis for patients with CKD stage 5. Hemodialysis comprised over 89% of procedures. Costs per a patient did not depend on gender and age.

CONCLUSION

Compulsory health insurance system costs for outpatient and inpatient management of CKD patients significantly increase with aggravation of disease. Terminal stage is the most expensive.