Table 1.

Description and source of the available macroeconomic indicators, general population health indicators, renal service organization indicators, incidence of dialysis, and incident dialysis population characteristics

Primary determinants Macroeconomics
  GDP per capita pppGDP per capita in US dollars (adjusted for ppp, which eliminates the differences in price levels between countries). Measure of national wealth.WHO HFA database, OECD Health database, WHO SIS database
  Healthcare expenditure as a percentage of GDPPercentage of GDP (i.e., national wealth) spent on healthcare.WHO HFA database, OECD Health database, World Bank NHP Stats
Secondary determinants
Renal service organization
  Private for-profit share of HD facilitiesPercentage of chronic outpatient HD facilities owned by the private (nongovernmental) for-profit sector.Expert questionnaire
  HD facility reimbursement as proportion of GDP per capitaAverage annual reimbursement rate for main center HD, including reimbursement of the nephrologist as a proportion of GDP per capita.Expert questionnaire; not available for New Zealand
  Prevalent dialysis patients per nephrologistAverage number of prevalent dialysis patients per nephrologist.Expert questionnaire
 Incidence of dialysisCrude incidence rate of dialysis per million population at day 91.Renal registry
 Incident dialysis population characteristics
  Percentage diabetes as primary renal diseasePercentage of incident patients with diabetes mellitus as the cause of ESRD.Renal registry
  Intrinsic age- and sex-related mortality risk of incident dialysis populationMeasure of the background mortality risk of the national dialysis population; based on the mortality of the general population and age and sex standardization (using 5-year age bands) of the incident dialysis population of that country. This intrinsic mortality risk has been identified as a determinant of mortality in RRT patients (6,7).Registry data and WHO mortality tables. Not available for Taiwan
Additional possible confounders
  Human development indexCombines indicators of life expectancy, education, and income to create a validated composite score of a nation’s state of development (46).Available from
  Responsiveness indexIndicator of healthcare system performance, with elements capturing respect for dignity, confidentiality, autonomy, prompt attention, quality of amenities, incidence of social support networks, and choice of provider (47).WHO
  Public share of healthcare expenditurePublic expenditure as a percentage of total expenditure on healthcare.WHO HFA database, OECD Health database, World Bank NHP Stats
General population health status indicators
  Cardiovascular mortalityCardiovascular mortality rates for the general population.WHO mortality tables; not available for Taiwan
  Life expectancy at age 60 yearsThe number of years an individual at 60 years old would be expected to live.Eurostat and OECD data; not available for Taiwan
 Renal service organization indicators
  HD facility reimbursement methodFacility reimbursement method (activity based versus global budget).Expert questionnaire
  Prevalent dialysis patients per dialysis centerAverage number of prevalent dialysis patients per dialysis center.Expert questionnaire
Incident dialysis population characteristics
  Mean ageMean age of the incident dialysis population.Renal registry
  Percentage of malesPercentage of males of the incident dialysis population.Renal registry
  • GDP, gross domestic product; ppp, purchasing power parity; WHO, World Health Organization; HFA, Health for All; OECD, Organization for Economic Cooperation and Development; SIS, Statistical Information System; NHP, National Health Policy; HD, hemodialysis; RRT, renal replacement therapy.