I would like to ask a question for those dialysis nurses out there working or have worked in an outpatient clinic. How do your patients get to Dialysis. I know many times I see patients admitted to the floor because they are in overload for missing their appointments due to lack of transportation. My question is are there any companies out there that bring these patients there or do they usually rely on family? What percentage of the patients that you see either need or have a transport service? Any details welcome.
Feb 21, '09
In my county in PA there are access vans that transport our pts. The pts. have to sign up for this service in advance. Once signed up the van picks them up and takes them home after tx. We encourage our pts. to use this service because it is safer than if they drove themself home after tx. There is a small fee for this service, however I don't know the exact price. The majority of our pts. use the vans. These vans also transport the elderly to grocery stores, beauty shops, etc.
Feb 22, '09
Thanks krups. Do you think the patients pay for this service or their insurance is billed?
Feb 22, '09
Our patients use a variety of transportation. Some are brought by services contracted through their nursing homes. Some use the Red Cross. A very small percentage come by cab. Our city also have several different private transportation services available - most of which take insurance.
Our social worker works with all our patients who are in need of transportation to make sure they have affordable transportation.
I know this sounds cynical, but I wouldn't always assume that the dialysis patients you see who missed treatments actually didn't have transportation available. It's more likely that they just didn't go for their own personal reasons, but don't want to admit it.
Feb 23, '09
Dialysis pts as a group are noncompliant. If they had been compliant with their diabetes and hypertension, many wouldn't be on dialysis. This carries over to dialysis and I can't even begin to tell you how many have a cab which their Medicaid covers come to their door and they refuse to come to dialysis.
Compliance is a huge issue.
I live in a rural area and at one unit - there are no cabs, busses, etc - either the pt drives or the family brings them and you know what - all of them always come too.
At one of my other unit, inner city, where all the pts have free transportation already arranged, I have a 20-30% no-show rate!
Feb 25, '09
our nursing home pts are brought in by contracted ambulances. Other drive themselves or rely on family. Many pts have medicaid taxi or the paratransit bus that works off the city bus system. I assume medicaid/care, whatever covers this, because the social worker receives their coupons for the bus and then hands them out. If they run out of coupons and don't reorder, they are out of luck. If they miss their ride, it counts against them with "the system". A couple ppl just don't care enough to get outside and wait for their bus, they miss their ride, they end up in the hospital with fluid overload because they "can't get a reschedule". It is frustrating sometimes.
Feb 27, '09
Thanks for replying. My question is what percentage of dialysis patients have you seen that are a)ambulatory, just needing transport for one reason or another or b) in a wheelchair, not obese. Thanks.
Feb 27, '09
More than 50% of mine depend solely on public transport. If none then there is absolutely no way for them to come. Holidays are a real issue for mine.
Feb 28, '09
I'd say at least 50 percent of all the patients in my clinic are amb, they just need a ride through public transport. about 40 percent have cars, family that bring them. the remaining 10 percent arrive via stretcher or wheelchair ambulance transport.
Mar 3, '09
The majority of our patients rely on transportation provided by Social Services. Medicaid pays for their transportation. Our county transportation goes by the public school schedule, so if school is out, the vans don't run. I think that is crazy because people's lives don't stop just because the kids are out of school for a holiday or whatever. Also if the weather is bad, sometimes we have to call the sheriff's dept to bring the patients in.
Mar 4, '09
So is this covered under Medicaid or Medicare?
Mar 7, '09
In NC, Medicaid pays for transportation. Medicare does not cover any transportation costs. I assume it is the same everywhere else as well, since Medicaid is state-controlled & Medicare is federal-controlled.
Mar 11, '09
So when the patients have transporation, I am sure the company does not wait and they have more than one patient, right? So do they usually spend some time waiting on other patients to get finished being dialyzed before the transport comes back after making a few more runs, or how does that part work?
Must Read Topics