Kidney failure is an under-discussed health crisis in the United States. As of 2018, 786,000 Americans were living with end-stage renal disease (ESRD for short). That same year, total Medicare spending on patients with ESRD reached $49 billion. The 30% of patients blessed to receive functioning kidney transplants cost the system far less than those still reliant on dialysis. As the system is structured today, dialysis is both necessary for the survival of ESRD patients and woefully unequipped to serve their needs. The inefficiency in the system is part of what drives the cost of hemodialysis to over $93,000 per patient annually.
Right now, the vast majority of dialysis occurs at outpatient clinics. This may be convenient for active, middle aged dialysis patients, but it ignores the fact that most people with ESRD don’t fit that mold. 80% of ESRD patients are 65 or older. Many live in nursing homes and are unable to transport themselves. For nursing homes to provide them transit can cost up to $411 per round trip. As recent experiences with pandemic disease have revealed, asking vulnerable populations to regularly travel to an outpatient clinic poses an infection risk to them, the nursing home staff, and other residents.
Nursing Home With Dialysis
There is a better way. If nursing homes provide dialysis on-site, they eliminate transportation costs and infection concerns. On-site, 3-day dialysis frees up hours of time per week, allowing residents to engage in therapies and social activities beneficial to their health. When less time is spent pursuing survival, more time can be allocated to thriving. Nursing home residents deserve to enjoy their final years of life. They shouldn’t waste it trapped in an inefficient system that slows the provision of life-sustaining treatment. Providing on-site dialysis care in a home-like setting is the way of the future.