A computer model for predicting the demand for end-stage renal failure (ESRF) treatment, contract setting and monitoring

Abstract

Background. The high cost of end-stage renal failure (ESRF) treatment, and the anticipated need for expansion of the service at a time of limited resources for health care expenditure, means that careful planning of such an expansion is necessary. This needs to inform the setting and monitoring of contracts between commissioning organizations and providers of treatment. A spreadsheet based computer model is described which fulfils both of these needs. Methods. A computer programme was written to run on a commonly available spreadsheet in order to predict the demand for ESRF treatment, set contracts, and monitor in year performance. Results. The model described has facilitated contracting for ESRF services. Purchasers have used it to examine various planning scenarios, while the provider unit has used it to support a business case for further development. Using this model, the predictions for the Sheffield resident population are that the total number of patients on the ESRF treatment programme will increase from a mid-year average of 204 patients in the year 1994-95 to 266 patients in the year 1999-2000, while costs increase over the same time period from £2.37 million to £2.78 million. Conclusions. A computer spreadsheet based model described is a useful tool for predicting demand, and setting and monitoring contracts, for treatment for ESRF. Problems with the model and potential further developments are discussed.