Epidemiology and hospitalization costs of chronic kidney disease in Romania

Ildiko Aliz Bradacs (), László-István Bába (), László Lorenzovici (), Andreea Mihaela Precup (), Szabolcs Farkas- Ráduly (), Gyongyi Tar (), Vasile Nastase (), Lucia Georgeta Daina (), Raul Bozu (), Gyula Jozsef Nagy (), Dimitrie Cristian Siriopol (), Dorel Sandesc (), Ovidiu Horea Bedreag (), Florin Buicu (), Gabriel Mircescu () and Gener Ismail ()
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Ildiko Aliz Bradacs: Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy
László-István Bába: Syreon Research Romania
László Lorenzovici: Syreon Research Romania
Andreea Mihaela Precup: Syreon Research Romania
Szabolcs Farkas- Ráduly: Syreon Research Romania
Gyongyi Tar: Sapientia Hungarian University of Transilvania
Vasile Nastase: Fundeni Clinical Institute
Lucia Georgeta Daina: University of Oradea
Raul Bozu: Clinical County Emergency Hospital of Oradea
Gyula Jozsef Nagy: University of Pecs
Dimitrie Cristian Siriopol: University of Suceava
Dorel Sandesc: Victor Babes University of Medicine and Pharmacy
Ovidiu Horea Bedreag: Victor Babes University of Medicine and Pharmacy
Florin Buicu: George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures
Gabriel Mircescu: “Carol Davila” University of Medicine and Pharmacy
Gener Ismail: “Carol Davila” University of Medicine and Pharmacy

Health Economics Review, 2025, vol. 15, issue 1, 1-12

Abstract: Abstract Background Chronic kidney disease or chronic renal failure is a progressive condition defined as abnormalities of kidney structure or function, present for longer than 3 months. It is estimated to affect more than 10% of the general population worldwide. Management of CKD represents an especially large burden for the health systems of low- and middle-income countries, and it has been recognized as a leading public health problem. Previous research articles reported an age-adjusted prevalence of 7.6% for Romania, but the hospital costs generated by CKD are unknown. The present research article aimed to measure the hospital costs and one-year national healthcare budget impact of CKD, excepting the chronic care costs of RRTs. Methods In this retrospective study we reviewed the electronic health records of 4 University, 3 County and 5 City hospitals from 1st of January 2019 to 31st of December 2019 in order to calculate costs related to hospitalization due to chronic kidney disease. Inclusion criteria were defined as: CKD-related diagnostic codes or dialysis-related procedures in medical cases (without surgical interventions). KDIGO severity grades 1-5 were considered, including dialysis costs. The costs generated by the chronic care of RRTs were not considered here. Hospitalization cost calculation was based on hospital controlling methodology including direct, indirect and overhead costs. For the national-level burden study, we analyzed the health claim records of all public and private hospitals for 2019. Results In 2019 a total number of 229 276 cases reported chronic kidney disease in Romania. The average hospital costs per patient episode was €917.1, with significantly higher costs in cases with complications or higher severity grades. The total hospitalization cost-related budget impact in 2019 was €210 million. Conclusions The high hospitalization costs of CKD (representing 2.6% of the NHIH budget, not considering the funds for sick leave) cause major impact on the national health payer`s budget. Preventive strategies, early diagnosis and management as well as health education measures could act as means of mitigation. Our results should warn the public health policy decision makers about the importance of this disease.

Keywords: Chronic kidney disease; Dialysis; Hospitalization cost; Budget impact (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1186/s13561-025-00614-x

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