Disease management programs for CKD patients: the potential and pitfalls

Area of Science:

• Nephrology
• Health Services Research
• Public Health

Background:

• Disease management programs aim to identify and treat chronic conditions, particularly costly ones.
• Programs for chronic kidney disease (CKD) have been established but face discontinuation due to high costs.

Purpose of the Study:

• To outline the unique challenges associated with implementing and sustaining disease management programs for CKD.
• To identify barriers to effective CKD disease management and suggest areas for future development.

Main Methods:

• Analysis of challenges in CKD patient identification, including coding and diagnostic criteria.
• Examination of the complexities in managing CKD's multi-systemic effects.
• Review of financial and data-related obstacles in CKD disease management program evaluation.

Main Results:

• CKD patient identification is hampered by incomplete ICD-9 code usage and inconsistent eGFR measurement.
• Comprehensive CKD management is more costly than for diseases like diabetes or heart failure.
• Lack of data for program development and the need for long-term outcome evaluation impede current contracting models.

Conclusions:

• Effective disease management for CKD is challenged by diagnostic and treatment complexities, high costs, and data limitations.
• Current short-term contract models are misaligned with the long-term observation needed for CKD management.
• Resolving these challenges is crucial for the sustained success of CKD disease management programs.