VA-Based Peritoneal Dialysis Program Feasibility Considerations and Process Outline.

Area of Science:

• Nephrology
• Public Health
• Healthcare Administration

Background:

• Home dialysis, particularly peritoneal dialysis (PD), shows lower utilization rates among veterans compared to the general US population.
• Sociodemographic factors and comorbidities are identified as key contributors to the underutilization of PD.
• The Veterans Health Administration (VHA) Kidney Disease Program Office established a dedicated PD workgroup in 2019 to address this disparity.

Purpose of the Study:

• To address the limited availability of peritoneal dialysis (PD) within the VHA system.
• To prevent fragmentation of care by enabling veterans to receive PD services at VHA facilities.
• To develop a standardized process for evaluating feasibility and establishing new PD programs within individual VAMCs.

Main Methods:

• The PD workgroup focused on creating a standardized process for VHA facilities to evaluate and establish PD programs.
• A three-phased approach was designed: prerequisite ascertainment, clinical and financial feasibility assessment, and business plan development.
• Data gathering and synthesis were central to examining the clinical and financial viability of PD programs.

Main Results:

• A comprehensive guide was developed to assist VAMCs in establishing or restructuring PD programs.
• The guide outlines a phased approach to systematically implement PD services.
• This initiative aims to improve therapeutic options for veterans with kidney failure.

Conclusions:

• VAMCs can utilize the developed guide to enhance treatment options for veterans with kidney failure.
• Establishing or restructuring PD programs within VAMCs is a key recommendation.
• The guide facilitates administrative approval processes for new PD programs within the VHA.