Home and medical center hemodialysis. Dollar comparison and payback period

B. G. Delano, M. V. Feinroth, M. Feinroth and E. A. Friedman

Cost of home hemodialysis training was compared with that of continuing hemodialysis at a satellite medical center. The "payback period" was defined as the time after which higher home training and start-up charges equaled and were surpassed by the initially lower satellite charges. This period was 14.4 months. Total cost of home hemodialysis training and start-up at our institution was $15,149.32. Ambulatory medical center hemodialysis during the same period (3 1/2 months) was $6,853.58. Initially, therefore, the cost of home dialysis is $8,295.74 more. However, after 14.4 months, there is an equalization point subsequent to which home hemodialysis costs $7,472.40 less each year. For a subgroup of patients, those with malignant and severe systemic diseases with reduced survival with hemodialysis, home hemodialysis has no economic advantage.