Help patients choose the right dialysis center
Since Medicare pays 80% of the cost of dialysis for any patient who needs the procedure and insurance usually picks up the remainder, patients have "a fair amount of freedom of choice" where they will go for their treatments, says Garabed Eknoyan, MD, a Baylor University professor of medicine and practicing nephrologist in Houston. Eknoyan is the National Kidney Foundation’s co-chairman for its Dialysis Outcomes Quality Initiative.
Since many patients have a little time — a few days, perhaps even a few weeks — to decide where they will obtain their treatment, they can make a considered choice with the help of their health care team, says Neil R. Powe, MD, MPH, MBA, professor of epidemiology, health policy management, and medicine at Johns Hopkins School of Public Health in Baltimore.
Both physicians make these recommendations:
• An early referral to a nephrologist is key to the best care — as soon as there is an indication that a patients are heading toward renal failure, say Powe and Eknoyan.
• Do the research yourself and make sure you are aware of all the available options, says Powe.
• Health care team members should help a patient think about the future and talk about options in the geographic area, since the patient will have dialysis three times a week for about three hours a treatment, says Powe.
• Look for a facility that is close to a medical center, says Eknoyan. Studies indicate the outcomes are better in this type of center.
• Find out how often a patient on dialysis is checked, says Eknoyan. Ideally, a nephrologist should check each patient during each dialysis treatment, he says, but realistically, the doctor should see the patient at least twice a week during dialysis.
"The federal regulations say twice a month is enough. I don’t think that is enough," he says.
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