Projecting the Number of Dialysis Patients with End-Stage Renal Disease in Taiwan to the Year 2020
Date Issued
2011
Date
2011
Author(s)
Chang, Hung-Wei
Abstract
The worldwide patients with end-stage renal disease are increasing and are estimated that there will be over two million patients in 2020. According to the United States Renal Data System 2010 Annual Report, Taiwan ranks first in the world in the incidence and the prevalence of end-stage renal disease. Moreover, the medical expenses will be under pressure by the increasing patients in Taiwan. Statistics from Bureau of National Health Insurance, Department of Health, Executive Yuan in 2010 indicated that the expenses of dialysis therapy contributed 7.88% of the total medical expenditure, but the patients on dialysis only accounted for 0.27% of the total population in Taiwan. Indeed, spending of the medical expenditure was at great expense of that the average expenses for one patient on dialysis is 26.4-fold than for any other person. Thus, the purpose of the present research is to use the historical data of the incidence and the prevalence to project the number of dialysis patients with end-stage renal disease in the year 2020, and then to help the Department of Health to optimize the budget and resource allocation and the prevention and control of the spread of end-stage renal disease.
In the present study, 114,996 patients with end-stage renal disease who were on dialysis for over continuous four months were chosen from National Health Insurance Research Database of 1997 to 2009. The prediction of incidence was estimated using autoregressive integrated moving average model (ARIMA), and the mortality was recorded by year to speculate the prevalence until 2020. The projecting number of patients with end-stage renal disease in 2020 using ARIMA (0, 3, 3) and ARIMA (p, d, q)better in 2008, respectively. The average year increase rate from 2009 to 2020 estimated by ARIMA (0, 3, 3) and ARIMA (p, d, q)better were 4.79% and 4.67%, respectively. The predicted prevalence in 2020 were 102,145 and 99,688 people speculated by ARIMA (0, 3, 3) + mortality and ARIMA (p, d, q)better + mortality, respectively, which were 1.7-fold than in 2008, and the year increase rate of prevalence were 4.85% and 4.68%.
Patients with diabetic nephropathy are the major contributors to the increase of the number of patients with end-stage renal disease. Based on the present prediction in 2020, there will be over 80% of patients on dialysis come from the patients with diabetes, and the patients with diabetic nephropathy will take almost 60% in the prevalence. Thus, efficiently lowering the number of patients with end-stage renal disease could depend on preventing course of disease into the end-stage by controlling actively the development of chronic kidney disease (CKD) which runs in the patients with diabetes.
Subjects
ESRD
dialysis
predict
time series
ARIMA
prevalence
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-100-R93843019-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):386ca107f860260a89b0ab5215a32ae5