Epidemiology and hospitalization costs of chronic kidney disease in Romania

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 espe...

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Main Authors: 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, Gener Ismail
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Health Economics Review
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Online Access:https://doi.org/10.1186/s13561-025-00614-x
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author 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
Gener Ismail
author_facet 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
Gener Ismail
author_sort Ildiko Aliz Bradacs
collection DOAJ
description 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.
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spelling doaj-art-d1f8fecf75a64d3282f81123b0e2562e2025-08-20T02:30:19ZengBMCHealth Economics Review2191-19912025-04-0115111210.1186/s13561-025-00614-xEpidemiology and hospitalization costs of chronic kidney disease in RomaniaIldiko Aliz Bradacs0László-István Bába1László Lorenzovici2Andreea Mihaela Precup3Szabolcs Farkas- Ráduly4Gyongyi Tar5Vasile Nastase6Lucia Georgeta Daina7Raul Bozu8Gyula Jozsef Nagy9Dimitrie Cristian Siriopol10Dorel Sandesc11Ovidiu Horea Bedreag12Florin Buicu13Gabriel Mircescu14Gener Ismail15Doctoral School of Biomedical Sciences, Faculty of Medicine and PharmacySyreon Research RomaniaSyreon Research RomaniaSyreon Research RomaniaSyreon Research RomaniaSapientia Hungarian University of TransilvaniaFundeni Clinical InstituteDepartment of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of OradeaClinical County Emergency Hospital of OradeaDoctoral School, Faculty of Health Sciences, University of PecsȘtefan cel Mare, University of SuceavaAnaesthesia and Intensive Care Medicine Department, Victor Babes University of Medicine and PharmacyAnaesthesia and Intensive Care Medicine Department, Victor Babes University of Medicine and PharmacyGeorge Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresDepartment of Nephrology, “Carol Davila” University of Medicine and PharmacyDepartment of Nephrology, “Carol Davila” University of Medicine and PharmacyAbstract 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.https://doi.org/10.1186/s13561-025-00614-xChronic kidney diseaseDialysisHospitalization costBudget impact
spellingShingle 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
Gener Ismail
Epidemiology and hospitalization costs of chronic kidney disease in Romania
Health Economics Review
Chronic kidney disease
Dialysis
Hospitalization cost
Budget impact
title Epidemiology and hospitalization costs of chronic kidney disease in Romania
title_full Epidemiology and hospitalization costs of chronic kidney disease in Romania
title_fullStr Epidemiology and hospitalization costs of chronic kidney disease in Romania
title_full_unstemmed Epidemiology and hospitalization costs of chronic kidney disease in Romania
title_short Epidemiology and hospitalization costs of chronic kidney disease in Romania
title_sort epidemiology and hospitalization costs of chronic kidney disease in romania
topic Chronic kidney disease
Dialysis
Hospitalization cost
Budget impact
url https://doi.org/10.1186/s13561-025-00614-x
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