The kidney failure crisis in the US is a commonly overlooked issue. In 2018, 786,000 Americans were living with end-stage renal disease (ESRD for short). The overwhelming majority of ESRD patients are over the age of 65. Despite that, the industry has prioritized the needs of active, middle-aged dialysis patients. In doing so, they have failed to address the needs of a growing nursing home population.
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Majority Of ESRD Patients Rely On Dialysis To Stay Alive
While some ESRD patients are fortunate enough to receive functioning kidney transplants, 70% of ESRD patients rely on dialysis to stay alive. Given the necessity and regularly-occurring nature of dialysis, one would think the service would be convenient to access. Instead, 86% of dialysis must be done at an outpatient clinic. Patients make the trek every few days to a clinic for lifesaving treatment. This can be a difficult trip for nursing home residents because clinics pose a greater infection risk to their health. Transportation to a dialysis clinic can be hard to obtain, especially if the nursing home does not provide it themselves. Furthermore, the most acute residents often struggle with placement at outpatient clinics.
If nursing homes were to provide on-site dialysis for their residents, the drawbacks of outpatient clinics could be eliminated. On-site dialysis allows better collaboration of care, fewer hospital readmissions, and stronger relationships with hospital partners. Nursing homes with on-site dialysis can accept higher acuity patients than those without. For nursing homes that offer transportation to clinics at present, on-site dialysis can eliminate costs as high as $411 per round trip.
When choosing between options for on-site dialysis, nursing homes should opt for 3-day on-site dialysis care over daily. 98% of nursing home dialysis patients are already accustomed to 3-day treatments. Switching them to daily dialysis requires prescription changes that may disrupt the continuity of care. Daily dialysis carries greater risk of hospitalization or surgery due to difficulties with the blood access site, blood clots, or aneurysms. Daily care also opens a greater possible window for missed treatments.
While quality of care considerations must come first, nursing homes also have cost savings to consider when electing to offer 3-day dialysis. For the same initial investment, on-site, 3-day dialysis provides treatment to 3 times more patients than daily dialysis can. With 6 chairs, 3-day dialysis supports up to 36 patients. Daily supports 12.
Large dialysis providers have ignored their nursing home patients too often. A new model is needed. Learn more about dialysis in nursing homes in the infographic below:
Infographic source: Concertors
