End-stage renal disease projections for Canada to 2005 using Poisson and Markov models

Background End-stage renal disease (ESRD) incidence and prevalence are increasing in many countries worldwide. Due to the high cost of therapy, predicting future numbers of patients requiring dialysis and transplantation is necessary for health care planners. Projecting therapy-specific chronic dise...

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Bibliographic Details
Published in:International journal of epidemiology 1998-04, Vol.27 (2), p.274-281
Main Authors: Schaubel, Douglas E, Morrison, Howard I, Desmeules, Marie, Parsons, Daria, Fenton, Stanley SA
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Canada - epidemiology
Demography
dialysis
end-stage renal desease
Epidemiology
Female
Follow-Up Studies
General aspects
Humans
Incidence
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - therapy
Kidney Transplantation
Male
Markov Chains
Markow model
Medical sciences
Methodology
Middle Aged
Poisson Distribution
Prevalence
projections
Public health. Hygiene
Public health. Hygiene-occupational medicine
Renal Dialysis
transplantation
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Summary:Background End-stage renal disease (ESRD) incidence and prevalence are increasing in many countries worldwide. Due to the high cost of therapy, predicting future numbers of patients requiring dialysis and transplantation is necessary for health care planners. Projecting therapy-specific chronic disease prevalence is inherently problematic, and examples of suitable models and their application are sparse. When applied, rarely was the adequacy of such models evaluated. Methods We describe and illustrate a method for projecting therapy-specific ESRD prevalence in Canada for 1995–2005 using data obtained from the Canadian Organ Replacement Register. The projections combine the Poisson model for incidence rates and a Markov model for patient follow-up. Model adequacy is empirically validated by data-splitting. Results Large increases in ESRD prevalence are expected in Canada, with an average annual increase of 6.9% projected for 1995–2005. Upon validation, the projection model based on 1981‐1987 data was able to predict 1994 prevalence within 1%, while projected therapy-specific prevalences closely approximated those observed. Conclusions Therapy-specific ESRD prevalence was successfully projected using Poisson and Markov models. Where multistate prevalence forecasts are required, the method could be augmented for application to various other chronic diseases.
ISSN:0300-5771
1464-3685
1464-3685
DOI:10.1093/ije/27.2.274