scholarly journals Measuring Patient Experience with Home Dialysis in the United States

2021 ◽  
Vol 16 (4) ◽  
pp. 508-510
Author(s):  
Brian M. Brady ◽  
Manjula Kurella Tamura
Keyword(s):  
United States ◽  
Patient Experience ◽  
The United States ◽  
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.

scholarly journals Home Infusions for Inflammatory Bowel Disease are Safe: United States Experience and Patient Perspectives

2021 ◽  
Author(s):  
Bharati Kochar ◽  
Yue Jiang ◽  
Wenli Chen ◽  
Yuting Bu ◽  
Edward L Barnes ◽  
...  
Keyword(s):  
United States ◽  
Inflammatory Bowel Disease ◽  
Patient Experience ◽  
Bowel Disease ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
States Experience

Abstract Background Home-infusions (HI) for biologic medications are an option for inflammatory bowel disease (IBD) patients in the United States (US). We aimed to describe the population receiving HI and report patient experience with HI. Methods We conducted a retrospective cohort study in the Quintiles-IMSLegacy PharMetrics Adjudicated Claims Database from 2010-2016 to describe the population receiving infliximab and vedolizumab HI and determine predictors for an urgent/emergent visit post-HI. We then administered a cross-sectional survey to IBD-Partners Internet-based cohort participants to assess knowledge and experience with infusions. Results We identified claims for 11,892 conventional infliximab patients, 1,573 home infliximab patients, 438 conventional vedolizumab patients and 138 home vedolizumab patients. There were no differences in demographics or median charges with infliximab home and conventional infusions. Home vedolizumab infusions had a greater median charge than conventional vedolizumab infusion. Less than 4% of patients had an urgent/emergent visit post-HI. Charlson comorbidity index >0 (OR:1.95, 95% CI:1.01-3.77) and Medicaid (OR:3.01, 95%CI:1.53-5.94) conferred significantly higher odds of urgent/emergent visit post-HI. In IBD-Partners, 644 IBD patients responded; 56 received HI. The majority chose HI to save time and preferred HI to conventional infusions. Only 2 patients reported an urgent/emergent visit for HI-related problems. Conclusions HI appears to be safe in IBD patients receiving infliximab and vedolizumab. However, patients with fewer resources and more co-morbidities are at increased risk for an urgent/emergent visit post-HI. The overall patient experience with HI is positive. Expansion of HI may result in decreased therapy-related logistic burden for carefully selected patients.

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.

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