Cost analysis and management strategies for hemodialysis service providers
Date Issued
2006
Date
2006
Author(s)
Lin, Yun-Lung
DOI
zh-TW
Abstract
End stage renal disease (ESRD) is a medical condition that causes significant financial and social burdens in today’s first world countries, and its management remains challenging.
However, our population is aging, rapidly accelerated by the generation of baby boomers; the prevalence of ESRD is on the rise because of the higher quality of care of renal replacement therapy; advances in medicine are extending life expectancies; and the presence of diabetes mellitus、hypertension 、dyslipidemia and other developed world diseases, makes ESRD even more difficult to manage.
Which method of renal replacement therapy leads us in the right direction? Supposing hemodialysis was the mainstay treatment how should it be operated? And what sort of strategies should dialysis service providers undertake to be able to withstand relevant political policy amendments? This research paper attempts to provide hemodialysis service providers insightful knowledge in the analysis and management strategies.
This study collected clinical data from 1,043patients in over ten sampled dialysis centers. By analysing mathematical means and variables to establish relationship trends, the below conclusions have been reached regarding each treatment costs : the cost per treatment is higher in female patients；increasing age is proportional to increasing treatment cost；the longer, and more stable the period of dialysis, the lower the costs, but there is a contrasting rise in cost approaching time of death ; patients suffering from hepatitis , diabetes mellitus or other combined diseases have higher treatment costs, with the exception of those who fill prescriptions in other outpatient departments, in which case costs of treatment are lower；the higher the Albumin、Hct of lab test data, the lower the costs of dialysis per treatment；urban centers have higher medical expenditures but rural centers have higher non-medical expenses,with total cost of single session dialysis being higher in urban centres. The abovementioned variable expenditures should be considered when merging currently existing dialysis units into a hemodialysis service providing network. Fixed costs, because of set up standards of dialysis unit, have a high proportion of personnel costs, for reaching a break-even point must over 600 patient sessions each month.Currently, about 20% more of hemodialysis centers fall below this break-even ponit. If the government wishes to maintain quality of care and continue suppressing treatment reimbursement fee, there must be regulations revised to allow the reuse of reprocessing dialyzers and reevaluating the set up standards of dialysis center.
According to the USRDS (The United States Renal Data System), kidney transplantation is the most effective form of renal replacement therapy, which should be more widely promoted by the government；In terms of survival rates, hemodialysis is placed second in R.R.T. (renal replacement therapy). To allow more effective use of social resources, the future of dialysis treatment should be localized chain-operating dialysis centers, as this is more effective operation and ensures a guaranteed standard of quality care . Merging and acquisition existing hemodialysis units to expand on an economical scale,plus integrate management to improve operating efficiency, is the best longstanding strategy for dialysis service provider.
Subjects
末期腎臟衰竭
腎臟替代療法
血液透析
血液透析醫療服務供應商
End stage renal disease
renal replacement therapy
hemodialysis
hemodialysis service provider
SDGs
Type
other
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