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The economic considerations of patients and caregivers in choice of dialysis modality
Introduction Broader adoption of home dialysis could lead to considerable cost savings for health services. Globally, however, uptake remains low. The aim of this study was to describe patient and caregiver perspectives of the economic considerations that influence dialysis modality choice, and elic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324572/ https://www.ncbi.nlm.nih.gov/pubmed/27196634 http://dx.doi.org/10.1111/hdi.12424 |
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author | Walker, Rachael C. Howard, Kirsten Tong, Allison Palmer, Suetonia C. Marshall, Mark R. Morton, Rachael L. |
author_facet | Walker, Rachael C. Howard, Kirsten Tong, Allison Palmer, Suetonia C. Marshall, Mark R. Morton, Rachael L. |
author_sort | Walker, Rachael C. |
collection | PubMed |
description | Introduction Broader adoption of home dialysis could lead to considerable cost savings for health services. Globally, however, uptake remains low. The aim of this study was to describe patient and caregiver perspectives of the economic considerations that influence dialysis modality choice, and elicit policy‐relevant recommendations. Methods Semistructured interviews with predialysis or dialysis patients and their caregivers, at three hospitals in New Zealand. Interview transcripts were analyzed thematically. Findings 43 patients and 9 caregivers (total n = 52) participated. The three themes related to economic considerations were: (i) productivity losses associated with changes in employment; (ii) the need for personal subsidization of home dialysis expenses; and (iii) the role of socio‐economic disadvantage as a barrier to home dialysis. Patients weighed the flexibility of home dialysis which allowed them to remain employed, against time required for training and out‐of‐pocket costs. Patients saw the lack of reimbursement of home dialysis costs as unjust and suggested that reimbursement would incentivize home dialysis uptake. Social disadvantage was a barrier to home dialysis as patients’ housing was often unsuitable; they could not afford the additional treatment costs. Home hemodialysis was considered to have the highest out‐of‐pocket costs and was sometimes avoided for this reason. Discussion Our data suggests that economic considerations underpin the choices patients make about dialysis treatments, however these are rarely reported. To promote home dialysis, strategies to improve employment retention and housing, and to minimize out‐of‐pocket costs, need to be addressed directly by healthcare providers and payers. |
format | Online Article Text |
id | pubmed-5324572 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53245722017-03-08 The economic considerations of patients and caregivers in choice of dialysis modality Walker, Rachael C. Howard, Kirsten Tong, Allison Palmer, Suetonia C. Marshall, Mark R. Morton, Rachael L. Hemodial Int Quality of Life, Outcomes Introduction Broader adoption of home dialysis could lead to considerable cost savings for health services. Globally, however, uptake remains low. The aim of this study was to describe patient and caregiver perspectives of the economic considerations that influence dialysis modality choice, and elicit policy‐relevant recommendations. Methods Semistructured interviews with predialysis or dialysis patients and their caregivers, at three hospitals in New Zealand. Interview transcripts were analyzed thematically. Findings 43 patients and 9 caregivers (total n = 52) participated. The three themes related to economic considerations were: (i) productivity losses associated with changes in employment; (ii) the need for personal subsidization of home dialysis expenses; and (iii) the role of socio‐economic disadvantage as a barrier to home dialysis. Patients weighed the flexibility of home dialysis which allowed them to remain employed, against time required for training and out‐of‐pocket costs. Patients saw the lack of reimbursement of home dialysis costs as unjust and suggested that reimbursement would incentivize home dialysis uptake. Social disadvantage was a barrier to home dialysis as patients’ housing was often unsuitable; they could not afford the additional treatment costs. Home hemodialysis was considered to have the highest out‐of‐pocket costs and was sometimes avoided for this reason. Discussion Our data suggests that economic considerations underpin the choices patients make about dialysis treatments, however these are rarely reported. To promote home dialysis, strategies to improve employment retention and housing, and to minimize out‐of‐pocket costs, need to be addressed directly by healthcare providers and payers. John Wiley and Sons Inc. 2016-05-15 2016-10 /pmc/articles/PMC5324572/ /pubmed/27196634 http://dx.doi.org/10.1111/hdi.12424 Text en © 2016 The Authors. Hemodialysis International published by Wiley Periodicals, Inc. on behalf of International Society for Hemodialysis. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Quality of Life, Outcomes Walker, Rachael C. Howard, Kirsten Tong, Allison Palmer, Suetonia C. Marshall, Mark R. Morton, Rachael L. The economic considerations of patients and caregivers in choice of dialysis modality |
title | The economic considerations of patients and caregivers in choice of dialysis modality |
title_full | The economic considerations of patients and caregivers in choice of dialysis modality |
title_fullStr | The economic considerations of patients and caregivers in choice of dialysis modality |
title_full_unstemmed | The economic considerations of patients and caregivers in choice of dialysis modality |
title_short | The economic considerations of patients and caregivers in choice of dialysis modality |
title_sort | economic considerations of patients and caregivers in choice of dialysis modality |
topic | Quality of Life, Outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324572/ https://www.ncbi.nlm.nih.gov/pubmed/27196634 http://dx.doi.org/10.1111/hdi.12424 |
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