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[Calculating the optimum size of a hemodialysis unit based on infrastructure potential]
Paula Avila-Palomares1, Malaquías López-Cervantes, Luis Durán-Arenas
1Unidad de Proyectos Especiales de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Delegación Coyoacán, México DF, México.
Objective:
To estimate the optimum size for hemodialysis units to maximize production given capital constraints.
Materials And Methods:
A national study in Mexico was conducted in 2009. Three possible methods for estimating a units optimum size were analyzed: hemodialysis services production under monopolistic market, under a perfect competitive market and production maximization given capital constraints.
Results:
The third method was considered best based on the assumptions made in this paper; an optimal size unit should have 16 dialyzers (15 active and one back up dialyzer) and a purifier system able to supply all. It also requires one nephrologist, five nurses per shift, considering four shifts per day.
Conclusion:
Empirical evidence shows serious inefficiencies in the operation of units throughout the country. Most units fail to maximize production due to not fully utilizing equipment and personnel, particularly their water purifier potential which happens to be the most expensive asset for these units.
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