Treatment of Chronic Kidney Failure:

Dialysis, Transplant Costs, and the Need for More Vigorous Efforts

HRD-78-17: Published: Nov 3, 1977. Publicly Released: Nov 3, 1977.

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A 1975 report on the treatment of chronic kidney failure was updated concerning mortality rates and costs for home versus institutional dialysis.

For the period 1972 to 1974, the National Institutes of Health data bank, the National Dialysis Registry, showed that mortality rates for home dialysis patients were slightly lower than for patients receiving treatment in dialysis centers. The 3-year mortality rates of home patients were 21.4% compared to 28.6% for patients treated in a facility. Based on current charges, the first year costs of home dialysis appear to be about the same as the costs for facility-based dialysis; whereas, the following year costs of home dialysis are about one-half the costs of facility-based dialysis. The first year cost of home dialysis is estimated to be $21,360; the following year costs for home dialysis based on 156 treatments a year are estimated to be $11,837. These costs are considered reasonable charges covered by Medicare and include equipment, training for 24 treatments, physician fees, backup dialysis for 16 treatments, and supplies and other for 116 treatments. Assuming 156 treatments a year, the annual cost for facility dialysis would be $23,400, which may be low because facilities (hospitals) have received exceptions for higher amounts. A rough estimate of home alterations required for home dialysis was $1,000. Under a current House bill, supplies and services not now covered by Medicare would be covered as an incentive to home dialysis.

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