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Patient selection in the Medicare End-Stage Renal Disease Program
1Department of Health Policy and Management, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205.
Medical Care
|October 1, 1988
Summary
Medicare End-Stage Renal Disease (ESRD) patient numbers and complexity are rising. An economic model shows that local demand and provider competition influence dialysis patient case mix.
Area of Science:
- Health Economics
- Nephrology
- Healthcare Management
Background:
- The Medicare End-Stage Renal Disease (ESRD) program has seen continuous growth in beneficiaries since 1972.
- ESRD patient demographics have shifted towards older individuals with more complex health conditions.
- Understanding the factors driving these changes is crucial for healthcare resource allocation.
Purpose of the Study:
- To develop and test an economic model explaining the case mix of dialysis providers.
- To identify key drivers influencing the characteristics of patients undergoing dialysis.
Main Methods:
- Utilized an economic model of dialysis providers.
- Employed administrative data from the Medicare ESRD program.
- Incorporated data from other relevant sources for comprehensive analysis.
Main Results:
- Dialysis patient case mix is significantly influenced by local area demand for medical care.
- Provider supply decisions are affected by market factors like competition and payment levels.
- These economic factors play a role in the evolving profile of ESRD patients.
Conclusions:
- Economic and market dynamics are key determinants of dialysis patient case mix.
- The findings offer insights into managing the increasing complexity of ESRD patient care.
- Policy and operational strategies should consider these economic influences on ESRD services.