In the United States, more than 550,000 end-stage renal disease (ESRD) patients rely on dialysis care, and annual medical insurance expenditures exceed 36 billion U.S. dollars. Among these patients, 65,000 people living In specialized nursing facilities (SNF) and long-term care (LTC) facilities. Due to improved treatments for cardiovascular disease, cancer and other comorbidities, life expectancy continues to increase, and the number of frail and/or elderly patients requiring dialysis in SNF or LTC facilities has increased dramatically. expected.
There are many ways to take patients to LTC facilities that require dialysis. In some cases, patients suffer from kidney failure and functional decline after catastrophic health events and long-term hospitalization. Sadly, the physical and cognitive abilities of many dialysis patients are deteriorating to the point that their care needs are beyond what can currently be addressed at home. The additional need for life-sustaining dialysis adds to the complexity of this combination.
For patients who live in specialized nursing facilities or long-term care facilities, they usually need to travel to and from the dialysis clinic 3 times a week, and usually need to take a special vehicle that can accommodate a wheelchair or stretcher. For frail and vulnerable patients, this is an exhausting and sometimes dangerous journey. In addition, the cost of this specialized transportation puts another undue burden on the patient, because transportation to and from the medical appointment—except in an emergency— Not covered by medical insurance.
Despite the need for innovation for many years, the Covid-19 pandemic has forced dialysis providers to consider better treatment models. The transportation to and from the dialysis center, the time spent waiting for treatment, and the time spent in close contact with other patients’ machines make it almost impossible to maintain social distancing. Therefore, an ongoing concern that does not have an immediate solution is the potential risk of transporting infected patients back to the care facility with other vulnerable patients.Explain the fatal impact of this challenge. To date, approximately 31% of Covid-19-related Death related to LTC facility In the United States.
Although the Covid-19 pandemic has further complicated the dialysis care of patients and providers, it is clear that traditional central dialysis has never “worked”. Actually, research shows Due to long treatment intervals on weekends, dialysis patient deaths and emergency room use rates are more likely to occur on Monday and Tuesday.
Especially the first 90 days of dialysis is still a period of high costs, high hospital admissions and high mortality.Lack of adequate pre-dialysis and transitional care is an important factor in this reality-nearly 40% of end-stage renal disease (ESKD) patients start dialysis Not fully prepared. So, what is the solution? A personalized nursing method that meets the needs of patients, reduces risks, and improves quality of life and outcomes. In many cases, this approach will include ensuring that patients effectively transition from central hemodialysis to home hemodialysis-no matter where the “home” is.
In fact, all routine dialysis should be performed in SNF and LTC facilities. This kind of nursing technology already exists, and training LTC staff in easy-to-operate portable dialysis equipment should become the norm. Equipment that can be learned to operate within 6 hours and used by a series of healthcare workers and patients. If widely adopted, it will not only reduce the cost burden, but more importantly, protect the safety and quality of life of the frail elderly we love. .
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