The Possible Impact of the Us Prospective Payment System (“Bundle”) on the Growth of Peritoneal Dialysis

Golper, Thomas A.

doi:10.3747/pdi.2013.00212

Cited by 28 publications

(25 citation statements)

References 6 publications

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“…International data suggest that patients’ ESKD treatment modality is influenced by their jurisdiction and health system factors, along with other patient factors such as socioeconomic status . The only existing Australian data examined patient socioeconomic status (as determined by residential postcode), which may correlate with PHI, and suggested that higher socioeconomic status is associated with more use of hospital or satellite HD and less use of PD .…”

Section: Introductionmentioning

confidence: 99%

Impact of supplemental private health insurance on dialysis and outcomes

Sriravindrarajah

Kotwal

Sen

et al. 2020

Internal Medicine Journal

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Background: The influence of health insurance systems on the treatment of end-stage kidney disease (ESKD) patients ispoorly understood.Aim: We investigated how supplemental private health insurance (PHI) coverage impacted ESKD treatment modalitiesand patient outcomes. The influence of health insurance systems on the treatment of end-stage kidney disease (ESKD) patients is poorly understood. We investigated how supplemental private health insurance (PHI) coverage impacted ESKD treatment modalities and patient outcomes.Methods: All adult patients commencing ESKD treatment in New South Wales, Australia from 2000 to 2010 were identified using the Australia and New Zealand Dialysis and Transplant Registry. Data were linked to the state hospitalisation dataset to obtain insurance status, allowing the comparisons of mortality, ESKD treatment modality and health service utilisation between privately insured and public patients.Results: The cohort of 5737 patients included 38% (n = 2152) with PHI. At 1 year after ESKD treatment initiation, PHI patients had lower mortality (hazard ratio 0.84, 95% confidence interval (CI) 0.74-0.95, P = 0.01), were more likely to be receiving home haemodialysis (HD) (odds ratio (OR) 1.38, 95% CI 1.01-1.89, P = 0.04), to have been transplanted (OR 1.75, 95% CI 1.25-2.46, P = 0.001) and used fewer hospital days (incidence rate ratio 0.85, 95% CI 0.74-0.96, P = 0.01). After adjustment, PHI patients were more likely to initiate ESKD treatment with facility-based HD (OR 1.22, 95% CI 1.01-1.46, P = 0.03) but were less likely to be started on peritoneal dialysis (OR 0.81, 95% CI 0.67-0.98, P = 0.03). Conclusion:Our findings suggest that supplemental PHI in Australia is associated with lower-risk ESKD treatment attributes and improved health outcomes. A greater understanding of the treatment pathways that deliver these outcomes may inform treatment for the broader ESKD treatment population.

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Section: Introductionmentioning

confidence: 99%

Impact of supplemental private health insurance on dialysis and outcomes

Sriravindrarajah

Kotwal

Sen

et al. 2020

Internal Medicine Journal

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“…The composite payment with capitation and bundling system has promoted the use of more home‐based therapies (Fig. ) …”

Section: United Statesmentioning

confidence: 99%

Addressing the burden of dialysis around the world: A summary of the roundtable discussion on dialysis economics at the First International Congress of Chinese Nephrologists 2015

Lui

et al. 2017

Nephrology

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ABSTRACT:To address the issue of heavy dialysis burden due to the rising prevalence of end-stage renal disease around the world, a roundtable discussion on the sustainability of managing dialysis burden around the world was held in Hong Kong during the First International Congress of Chinese Nephrologists in December 2015. The roundtable discussion was attended by experts from Hong Kong, China, Canada, England, Malaysia, Singapore, Taiwan and United States. Potential solutions to cope with the heavy burden on dialysis include the prevention and retardation of the progression of CKD; wider use of home-based dialysis therapy, particularly PD; promotion of kidney transplantation; and the use of renal palliative care service.

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“…For example, the US adopted a prospective payment system in 2011 providing equal payment regardless of dialysis modality (thus reimbursing peritoneal dialysis higher than its cost), which was associated with a 30%-40% relative increase in incident peritoneal dialysis use. 8,[12][13][14] This together with other research 11,15,16 suggests that facility-level reimbursement can affect peritoneal dialysis use, particularly in profit-driven systems.…”

mentioning

confidence: 90%