Why Do Not More Clinics Push Home Dialysis?

westieluv · Jul 2, 2014

I think we covered "why" already in several posts. Most of our patients prefer IN-CENTER dialysis. Again, if they choose not, despite being educated, what would you have us do? We even go as far as have current home dialysis patients come in and talk up the benefits you outlined here, to potential home dialysis folks. Not sure what else we could do. Oh and I am in Fresenius.

Do you think the day will come where patients will be forced into home HD? The majority of the patients in our chronic unit have no desire for home HD, because they prefer to come in, stay for their allotted time, and then go home and forget about it until their next treatment, inasmuch as they can forget it, considering their dietary and fluid restrictions.

So this leads me to wonder...if the government decides that home hemo MUST be "the wave of the future" because it will save them billions of dollars, would they find a way to force people into it? Maybe make it so that those on home hemo get a full ride, cost wise, while those in ICD would start to have a co-pay of some kind?

I know it doesn't seem feasible, but when it comes to the government and healthcare payouts, stranger things have happened.

Trauma Columnist · Jul 2, 2014

As an APN I am seeing that while home hemo is what the govt ie CMS seems to prefer, you all are right in that home hemo is not an option for many for a variety of reasons.

ausrnurse · Jul 2, 2014

Australia is really big on home haemo. It is much, much cheaper than in-centre dialysis and has better outcomes for the patients. There is nothing not to like about it in terms of the benefits for the patient. However, patients refuse to do it. The majority would prefer to have someone else do their dialysis for them and people are still non-compliant at home - except we don't know about it until it's too late. As stated above, many people do not have someone willing to help them. For PD, I don't believe the patients need a helper but for HD they absolutely do. It's a safety issue.