Structured outpatient peritoneal dialysis catheter insertion is safe and cost-saving

Perit Dial Int. 2014 Sep-Oct;34(6):612-7. doi: 10.3747/pdi.2012.00121. Epub 2013 Jul 1.

Abstract

Background: Data about outcomes and costs for peritoneal catheter insertion on an outpatient basis are scarce.

Methods: Using patient files, all peritoneal dialysis (PD) catheter insertions performed between 2004 and 2009 in a single-center tertiary care institution for adult patients were located. Patient demographics, complications, hospitalizations, survival, and treatment modality changes were recorded. Procedure-related expenses were valued as actual production costs.

Results: During the study period, 106 PD catheters were inserted. In 46 cases, the patients were admitted electively for catheter insertion; 19 catheters were placed during admission for other medical reasons; and 41 catheters were placed on an outpatient basis. Among the study patients (54.7 ± 16.0 years of age), 45% were diabetic. Early (<30 days) catheter-related complications occurred in 22% of patients. The incidences of technique failure and any complication within 90 days were 10% and 38% respectively. The occurrence of complications was not statistically significantly different for outpatients and electively admitted patients. Average costs for catheter insertion were higher in electively hospitalized patients than in outpatients (€2320 ± €960 vs €1346 ± €208, p < 0.000).

Conclusions: Compared with an inpatient procedure, outpatient insertion of a PD catheter results in similar outcomes at a lower cost.

Keywords: Peritoneal dialysis catheter; costs; insertion; outpatients; peritonitis; technique failure.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities
  • Ambulatory Surgical Procedures / economics
  • Ambulatory Surgical Procedures / methods*
  • Catheters, Indwelling / economics*
  • Cohort Studies
  • Cost Savings*
  • Female
  • Finland
  • Humans
  • Inpatients / statistics & numerical data
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data
  • Patient Safety
  • Peritoneal Dialysis / economics*
  • Peritoneal Dialysis / instrumentation*
  • Retrospective Studies
  • Tertiary Care Centers
  • Treatment Outcome
  • Young Adult