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THE EFFECT OF PERITONEAL DIALYSIS ON LABOR MARKET OUTCOMES  COMPARED WITH INSTITUTIONAL HEMODIALYSIS
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
Department of Clinical Sciences, Lund, SWE.
Department of Clinical Sciences, Lund, SWE.
2019 (English)In: Peritoneal Dialysis International, ISSN 0896-8608, E-ISSN 1718-4304, Vol. 39, no 1, p. 59-65Article in journal (Refereed) Published
Abstract [en]

 ♦ Background: The aim of this study is to compare the impact of peritoneal dialysis (PD) and institutional hemodialysis (IHD), the 2 most common dialysis modalities, on employment, work income, and disability pension in Sweden.  ♦ Methods: Included in this study were 4,734 patients in IHD and PD, aged 20 – 60 years, starting treatment in Sweden during 1995 – 2012, and surviving the first year of dialysis therapy. Both “intention to treat” and “on treatment” analyses were performed by including transplant patients into the former and censoring them at the date of transplant in the latter analysis. A reduced bias treatment effect of PD vs IHD on labor market outcomes was estimated while accounting for non-random selection into treatment.  ♦ Results: Peritoneal dialysis was found to be associated with a 4-percentage-point increased probability of employment compared with IHD in the “on treatment” analysis. Also, PD was associated with a reduced disability pension by 6 percentage points, as well as increased work income (EUR 3,477 for employed) compared with IHD during the first year of treatment. The “intention to treat” analysis tended to give higher effect sizes compared with “on treatment.”  ♦ Conclusions: The results indicate that PD is associated with a treatment advantage over IHD in terms of increased employment, work income, and reduced disability pension in the Swedish population after controlling for non-random selection into treatment.

Place, publisher, year, edition, pages
multimed Inc. , 2019. Vol. 39, no 1, p. 59-65
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:bth-17091DOI: 10.3747/pdi.2017.00236ISI: 000456823000009OAI: oai:DiVA.org:bth-17091DiVA, id: diva2:1253519
Available from: 2018-10-05 Created: 2018-10-05 Last updated: 2020-10-28Bibliographically approved
In thesis
1. Cost-effectiveness analysis of an mHealth application (SMART4MD) and analysis of the effect of dialysis treatments on labor market outcomes: Health technology assessment of two treatment methods
Open this publication in new window or tab >>Cost-effectiveness analysis of an mHealth application (SMART4MD) and analysis of the effect of dialysis treatments on labor market outcomes: Health technology assessment of two treatment methods
2020 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Health Technology Assessment is an important factor for decision making in the healthcare sector in Sweden. It helps to curtail the rising costs associated with the healthcare sector and aids in the efficient allocation of scarce public health resources. This thesis investigates the cost-effectiveness and the effectiveness in general of two health technologies, addressing the following research objectives: i) assessing the cost-effectiveness of mobile health (mHealth) interventions designed for older adults diagnosed with mild cognitive impairment, and ii) assessing the effectiveness of peritoneal dialysis (PD) treatment on labor market outcomes in comparison with institutional hemodialysis (IHD) treatment in Swedish settings.

Study I and Study II are related to the first research objective. In Study I, we summarized and critically assessed the current evidence on the cost-effectiveness of mHealth interventions focusing on older adults; we found some evidence supporting the cost-effectiveness of these interventions. In Study II, we conducted a within-trial cost-effectiveness analysis of the software application Support, Monitoring and Reminder Technology for Mild Dementia (SMART4MD) from a healthcare perspective for a period of six months. A total of 345 Swedish dyads (MCI patient and informal caregiver) participated in this study. For a short time period of six months, we found that SMART4MD is not cost-effective for MCI patients (statistically insignificant); however, a trend was observed that indicated that it might be cost-effective for informal caregivers, although results remained statistically insignificant (p > 0.05).

Study III is related to the second research objective. In Study III, we investigated the effect of PD on labor market outcomes (employment rate, work income, and disability pension) in comparison to IHD. We found that PD is associated with a treatment advantage over IHD in terms of increased employment, work income, and reduced disability pension in the Swedish population after controlling for non-random selection for the treatment.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2020. p. 35 (kappa)
Series
Blekinge Institute of Technology Licentiate Dissertation Series, ISSN 1650-2140 ; 7
Keywords
Aged, Cost-benefit analysis, Gerontechnology, Telemedicine, Elderly, Mobile application, mHealth, Mobile health
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:bth-20587 (URN)978-91-7295-412-0 (ISBN)
Available from: 2020-10-29 Created: 2020-10-28 Last updated: 2021-02-08Bibliographically approved

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