Nocturnal Haemodialysis - A Preliminary Cost Comparison with Conventional Haemodialysis in Australia
Bibliographic record
Abstract
A 6 night/wk, home-based, government funded nocturnal haemodialysis (NHDx) program, believed to be the first outside North America, commenced in July 2001. Previously published Canadian and US costs suggest NHDx to be more cost-efficient than conventional haemodialysis (CHDx) as, although consumable-expensive, NHDx is home-based and is thus highly infrastructure, wage and hospital inpatient bed-day efficient. Comparable Australian cost evaluation is essential, however, before NHDx is widely encouraged as a new modality here. Cost comparisons for 3 × wk CHDx vs preliminary costs for 9/12 pts on 6 × wk NHDx (3 excluded for inadequate program time) include: consumables/fluids CHDx @$A8781/pt/yr vs NHDx @$A17562/pt/yr; estimated nursing costs CHDx (62.25 nurse hrs/wk with a nurse/pt ratio of 3:9)@$A12666/pt/yr vs NHDx (40 nurse hrs/wk with a nurse/pt ratio of 1:9)@$A8111/pt/yr with projected reduction to A$4866 for nurse/pt ratio of 1:15; pharmaceutical costs (includes all medication & Fleet® for dialysate but excludes EPO/iron polymaltose) CHDx one month prior to NHDx @$A1412/pt/yr vs NHDx costs after one month starting home-based treatment @$A1273/pt/yr. Though the NHDx pts have been carefully selected, only 3 hospitalizations for a total of 4 bed-days have been necessary in 348.5 pt wks of experience to September 2002. Our preliminary cost analyses confirm prior North American data. Cumulative financial modeling shows NHDx is more costly than CHDx at low pt numbers, reaching approximate equivalence @ 12 pts and progressively dropping below CHDx costs thereafter. NHDx appears cost-competitive with CHDx whilst yielding superior biochemical, life-style and rehabilitation results (see accompanying clinical data abstract).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".