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High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System

Background: The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. Objectives: To estimat...

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Autores principales: Stephens, J. Mark, Brotherton, Samuel, Dunning, Stephan C., Emerson, Larry C., Gilbertson, David T., Gitlin, Matthew, McClellan, Ann C., McClellan, William M., Shreay, Sanatan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Columbia Data Analytics, LLC 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471411/
https://www.ncbi.nlm.nih.gov/pubmed/37662025
http://dx.doi.org/10.36469/9861
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author Stephens, J. Mark
Brotherton, Samuel
Dunning, Stephan C.
Emerson, Larry C.
Gilbertson, David T.
Gitlin, Matthew
McClellan, Ann C.
McClellan, William M.
Shreay, Sanatan
author_facet Stephens, J. Mark
Brotherton, Samuel
Dunning, Stephan C.
Emerson, Larry C.
Gilbertson, David T.
Gitlin, Matthew
McClellan, Ann C.
McClellan, William M.
Shreay, Sanatan
author_sort Stephens, J. Mark
collection PubMed
description Background: The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. Objectives: To estimate US dialysis transportation costs from a purchaser’s perspective, and to estimate cost savings that could be achieved if less expensive means of transport were utilized. Methods: Costs were estimated using an actuarial model. Travel distance estimates were calculated using GIS software from patient ZIP codes and dialysis facility addresses. Cost and utilization estimates were derived from fee schedules, government reports, transportation websites and peer-reviewed literature. Results: The estimated annual cost of dialysis transportation in the United States is $3.0 billion, half of which is for ambulances. Most other costs are due to transport via ambulettes, wheelchair vans and taxis. Approximately 5% of costs incurred are for private vehicle or public transportation use. If ambulance use dropped to 1% of trips from the current 5%, costs could be reduced by one-third. Conclusions: Decision-makers should consider policies to reduce ambulance use, while providing appropriate levels of care.
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spelling pubmed-104714112023-09-01 High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System Stephens, J. Mark Brotherton, Samuel Dunning, Stephan C. Emerson, Larry C. Gilbertson, David T. Gitlin, Matthew McClellan, Ann C. McClellan, William M. Shreay, Sanatan J Health Econ Outcomes Res Nephrologic/Hepatologic Conditions Background: The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. Objectives: To estimate US dialysis transportation costs from a purchaser’s perspective, and to estimate cost savings that could be achieved if less expensive means of transport were utilized. Methods: Costs were estimated using an actuarial model. Travel distance estimates were calculated using GIS software from patient ZIP codes and dialysis facility addresses. Cost and utilization estimates were derived from fee schedules, government reports, transportation websites and peer-reviewed literature. Results: The estimated annual cost of dialysis transportation in the United States is $3.0 billion, half of which is for ambulances. Most other costs are due to transport via ambulettes, wheelchair vans and taxis. Approximately 5% of costs incurred are for private vehicle or public transportation use. If ambulance use dropped to 1% of trips from the current 5%, costs could be reduced by one-third. Conclusions: Decision-makers should consider policies to reduce ambulance use, while providing appropriate levels of care. Columbia Data Analytics, LLC 2013-08-28 /pmc/articles/PMC10471411/ /pubmed/37662025 http://dx.doi.org/10.36469/9861 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Nephrologic/Hepatologic Conditions
Stephens, J. Mark
Brotherton, Samuel
Dunning, Stephan C.
Emerson, Larry C.
Gilbertson, David T.
Gitlin, Matthew
McClellan, Ann C.
McClellan, William M.
Shreay, Sanatan
High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_full High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_fullStr High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_full_unstemmed High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_short High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_sort high costs of dialysis transportation in the united states: exploring approaches to a more cost-effective delivery system
topic Nephrologic/Hepatologic Conditions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471411/
https://www.ncbi.nlm.nih.gov/pubmed/37662025
http://dx.doi.org/10.36469/9861
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