Introduction
Patients with advanced chronic kidney disease have, in summation to transplantation and hospice c are, two choices for renal replacement therapy: hemodialysis and peritoneal dialysis. hospital systems typic all in ally incur the bombasticst cost when these patients are to the highest degree to initiate dialysis and right after the start of dialysis. Reasons for this hold: needed procedures to establish a vascular access, emergency room visits with sequent yardbird stays for unplanned dialysis starts, emergent inpatient hemodialysis, and physical exertion of interventional radiology to place tunneled and untunneled dialysis catheters.
Characteristics of patients that will incur the highest costs include:
1. Emergent need for dialysis
2. Starting hemodialysis with a catheter sort of than with a fistula or graft
3. Starting dialysis as an inpatient rather than an outpatient
During the months surveyed in 2009, some 70% of all patients starting hemodialysis fit some or all of these criteria. Notably, of the remain 30% virtually all had been enrolled in the Chronic Kidney complaint Management Program.
Importance of vascular access for cost containment
tenfold studies have shown that a fistula is the best on approximately cost-effective vascular access, followed by a graft, and that having a catheter as hemodialysis access is by far the worst, having not scarce the highest initial cost, but also the highest re-admission rates for serious events much(prenominal) as catheter-related bacteremias, which in most cases have to be born(p) by the hospital system given that a large number of patients are uninsured or underinsured.
70% of all patients starting hemodialysis at Jackson Memorial Hospital do so with the worst possible access, namely a tunneled venous catheter.
Barriers for decreasing the number of catheter-dependent hemodialysis patients
Currently, there are three obstacles preventing a decrease in the number of patients development catheters:
1. Only a...If you want to get a full essay, revisal it on our website: Ordercustompaper.com
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