Krahn MD, Bremner KE, de Oliveira C, et al. - Researchers assessed publicly-paid healthcare expenses (2015 Canadian dollars; 1 = 0.947 US dollar) and survival among patients aged ≥ 18 years who started chronic dialysis and had received facility hemodialysis (HD), facility short daily or slow nocturnal HD, peritoneal dialysis (PD), home HD as initial modalities, to ultimately determine if initiating with home HD or PD may decrease costs and improve outcomes. In this population-based study in Ontario, Canada, 12,691 patients were included and linked administrative data were used. Findings revealed the cost-effectiveness of initiating dialysis at home, which led to lower costs and better survival as compared with initiating with facility HD, this was indicated by new population-based evidence generated in this investigation in a large cohort over 9 years. After adjustment for baseline features, the persistence of survival differences was seen but experts could not adjust for functional status or severity of comorbidities.