Funding Innovative Dialysis Technology in the United States: Home Dialysis and the ESRD Transitional Add-on Payment for New and Innovative Equipment and Supplies (TPNIES)

2021 ◽  
Author(s):  
Yuvaram N.V. Reddy ◽  
Mallika L. Mendu ◽  
Eric D. Weinhandl
Keyword(s):  
United States ◽  
The United States ◽  
Equipment And Supplies ◽  
Home Dialysis

Home Dialysis in the New USA Bundled Payment Plan: Implications and Impact

2011 ◽  
Vol 31 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Thomas A. Golper ◽  
Steven Guest ◽  
Joel D. Glickman ◽  
Joe Turk ◽  
Joseph P. Pulliam
Keyword(s):  
United States ◽  
The United States ◽  
Fee For Service ◽  
Home Dialysis ◽  
Bundled Payment ◽  
Service Environment ◽  
Diverse Backgrounds ◽  
The Usa ◽  
Medicare Patients ◽  
The Government

On 1 January 2011, a new payment system for Medicare patients will be implemented in the United States. This new system bundles services previously charged separately and under a “fee for service” environment. The authors discuss the implications of this approach. Over the next several pages is a response by American physicians and dialysis innovators to a federal initiative to change the way dialysis is paid for in the United States. Peter Blake, the Editor-in-Chief of Peritoneal Dialysis International, invited Thomas Golper to articulate physicians’ concerns with this new payment scheme. After the government of the USA closed its comment period over the new payment methodology, called “bundling,” Golper sought out colleagues from diverse backgrounds and compiled this collective view of the situation.

Major Trauma (DRAFT)

2018 ◽  
Author(s):  
Patrick R. Varley ◽  
Louis H. Alarcon
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Major Trauma ◽  
Trauma Team ◽  
The United States ◽  
Equipment And Supplies ◽  
Traumatic Injuries ◽  
The Past ◽  
Trauma Teams ◽  
Injured Patients

Trauma is a leading cause of death and disability in the United States. Although it is generally considered to occur mostly outside of the hospital, traumatic injuries may occur anywhere. Outcomes for patients experiencing major trauma are closely linked to the healthcare response. Appropriate responses to traumatic injuries have been developed over the past 50 years, and are now considered to involve the care of a well-trained trauma team. This team utilizes established protocols to rapidly evaluate and treat injured patients. This chapter discusses the evolution of trauma teams, equipment and supplies, and the primary, secondary, and tertiary surveys used in trauma team response.

scholarly journals Travel Distance and Home Dialysis Rates in the United States

2014 ◽  
Vol 34 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Suma Prakash ◽  
Rick Coffin ◽  
Jesse Schold ◽  
Steven A. Lewis ◽  
Douglas Gunzler ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Travel Distance ◽  
Home Dialysis ◽  
Future Studies ◽  
Logistic Regression Models ◽  
Dialysis Facility ◽  
Dialysis Facilities ◽  
Specific Barriers ◽  
Travel Distances

IntroductionRural residence is associated with increased peritoneal dialysis (PD) utilization. The influence of travel distance on rates of home dialysis utilization has not been examined in the United States. The purpose of this study was to determine whether travel distances to the closest home and in-center hemodialysis (IHD) facilities are a barrier to home dialysis.MethodsThis was a retrospective cohort study of patients aged ≥ 18 years initiating dialysis between 2005 and 2011. Unadjusted PD and home hemodialysis (HHD) rates were compared by travel distances to both the closest home dialysis and closest IHD facilities. Adjusted PD and HHD utilization rates were examined using multivariable Logistic regression models.ResultsThere were 98,608 patients in the adjusted analyses. 55.5% of the dialysis facilities offered home dialysis. IHD, PD and HHD patients traveled median distances of 5.4,3.5 and 6.6 miles respectively to their initial dialysis facilities. Unadjusted analyses showed an increase in PD rates and decrease in HHD rates with increased travel distances. Adjusted odds of PD and HHD were 1.6 and 1.2 respectively for a ten mile increase in distance to the closest home dialysis facility, while for distances to the closest IHD facility the odds ratios for both PD and HHD were 0.7 (all p< 0.01).ConclusionsIn metropolitan areas, PD and HHD generally increased with increased travel distance to the closest home dialysis facility and decreased with greater distance to an IHD facility. Examination of travel distances to PD and HHD facilities separately may provide further insight on specific barriers to these modalities which can serve as targets for future studies examining expansion of home dialysis utilization.

scholarly journals Home Dialysis in the United States: A Roadmap for Increasing Peritoneal Dialysis Utilization

2020 ◽  
Vol 75 (3) ◽  
pp. 413-416 ◽  
Author(s):  
Erin P. Flanagin ◽  
Yashodhan Chivate ◽  
Daniel E. Weiner
Keyword(s):  
United States ◽  
Peritoneal Dialysis ◽  
The United States ◽  
Home Dialysis

scholarly journals Home Dialysis in the United States: To Increase Utilization, Address Disparities

2020 ◽  
Vol 2 (2) ◽  
pp. 95-97 ◽  
Author(s):  
Daniel E. Weiner ◽  
Klemens B. Meyer
Keyword(s):  
United States ◽  
The United States ◽  
Home Dialysis

A Comparative Analysis of the Emergency Medical Services and Rescue Responses to Eight Airliner Crashes in the United States, 1987–1991

1995 ◽  
Vol 10 (3) ◽  
pp. 142-153 ◽  
Author(s):  
Paul B. Anderson
Keyword(s):  
United States ◽  
Emergency Medical Services ◽  
Common Factors ◽  
The United States ◽  
Medical Services ◽  
Case Review ◽  
Structured Interviews ◽  
Equipment And Supplies ◽  
Patient Transport ◽  
Emergency Medical

AbstractIntroduction:Crashes involving commercial airliners stress emergency medical services (EMS) and rescue operations to performance far in excess of everyday activities, and special adaptations of everyday responses need to be implemented. Fortunately, these events are infrequent and usually do not occur more than once in any location. The responses that occur must be highly coordinated and efficient. Little is known about the responses to such events. This study examines the EMS and rescue responses associated with eight recent crashes involving commercial airliners in the United States.Objective:To identify common factors for which alterations in responses may enhance the survival and decrease the morbidity to victims involved in commercial aviation crashes.Study population:Eight commercial airliner crashes in the United States from 1987 through 1991.Methods:Case review using: 1) press and media accounts; 2) U.S. National Transportation and Safety Board testimony and reports; and 3) structured interviews with airport, fire, EMS, and hospital personnel. Data were collated and common factors identified for the cases. Findings are classified into: 1) conditions at the crash sites; 2) initial responses; 3) scene management; 4) scene status; 5) patient transport; 6) hospital responses; and 7) preplanning exercises.Results:Common factors that impaired responses for which some remediation is possible include: 1) new methods for training including computerized simulations; 2) improvements in rescue-extrication equipment and supplies; 3) stored caches of EMS equipment and supplies at airports; 4) ambulance transport capabilities; and 5) augmentation of patient transport capabilities.Conclusions:Many lessons can be learned through structured studies of commercial aircraft crashes. These findings suggest that simple and relatively inexpensive modifications may enhance all levels of emergency response to such events.

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