What holds short daily and NHHD back? Why not for everyone?
The HMO’s in the US (the health management organisations which are the funding bodies for much of the dialysis done in the US) are, understandably, anxious about cost blowouts from more frequent dialysis techniques – whether in the home or in a centre. One cant blame them. The ‘upfront costs’ are higher as NHHD uses more machines and more dialysers, lines and fluids. Later on though, the savings accrued from reduced staffing and infrastructure more than make up for the added consumable and equipment expenditure. But, the math is irresistible! Higher upfront costs actually do translate into lower long-term expenditure and cheaper programs yet with far, far better patient outcomes. However, and here’s the nub of the problem, the benefits really dont begin to outweigh the early costs until a program has gained a ‘critical patient mass’. In our experience, this amounts to a program of ~10-12 patients in an enhanced frequency NHHD program. This makes it hard for programs to start because th
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- What holds short daily and NHHD back? Why not for everyone?
