Cost Analysis of Hospital Treatment for Peritoneal Dialysis-Associated Peritonitis

Milorad  Stojadinovic; Radica  Zivkovic Zaric; Dejan  Petrovic; Aleksandra  Kezic; Milan  Radovic; Svetlana Jovicic  Pavlovic; Ivana  Mrdja; Lara Hadzi  Tanovic; Violeta  Knezevic; Dejan  Pilcevic; Tamara  Jemcov; Marija  Karapandzic; Slobodan  Jankovic

doi:10.18502/ijph.v54i6.18900

Milorad Stojadinovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Radica Zivkovic Zaric Department of Pharmacology and toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Dejan Petrovic Department of Nephrology, University Clinical Center Kragujevac, Kragujevac, Serbia
Aleksandra Kezic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Milan Radovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Svetlana Jovicic Pavlovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Ivana Mrdja Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Lara Hadzi Tanovic Department of Nephrology, University Clinical Center Serbia, Belgrade, Serbia
Violeta Knezevic Department of Nephrology, University Clinical Center Vojvodina, Novi Sad, Serbia
Dejan Pilcevic Department of Nephrology, Medical Military Academy, Belgrade, Serbia
Tamara Jemcov Department of Internal medicine, Medical Faculty, University of Belgrade, Belgrade, Serbia
Marija Karapandzic Department of Nephrology, General Hospital Zemun, Belgrade, Serbia
Slobodan Jankovic Department of Pharmacology and toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

DOI: https://doi.org/10.18502/ijph.v54i6.18900

Keywords: Peritoneal dialysis; Peritonitis; Costs

Abstract

Background: Increasing healthcare spending is a significant issue, with the aging population contributing to a rise in patients needing renal replacement therapy. The cost of peritoneal dialysis (PD) is substantial, particularly in upper-middle-income countries like Serbia. We aimed to identify the direct costs and influencing factors of treating peritoneal dialysis-associated peritonitis (PD associate peritonitis) in Serbia.

Methods: A retrospective observational study was conducted on consecutive patients admitted due to PD-associated peritonitis in five tertiary care hospitals across Serbia in 2019-2022. The primary outcome was total cost of hospitalization. Potential predictors were determined using generalized linear model with a gamma probability distribution and a log link function.

Results: The study included 122 patients. The average total cost per patient was 1131.90±1538.67 USD, with the cost of hospitalization (348.17 ± 361.52 USD) and antibiotics (294.94±465.88 USD) being the most significant. The length of hospitalization (P<0.001) and treatment outcome (P<0.001) were found to be significant predictors of the total cost.

Conclusion: The costs of treating PD associate peritonitis in Serbia are substantial, with each additional day of hospitalization significantly increasing the cost. The importance of patient and doctor education about infection prevention is underscored by the health consequences and the lengthy, expensive treatment when an infection occurs.