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System-Level Strategies to Improve Home Dialysis: Policy Levers and Quality Initiatives.
Suzanne Watnick1,2,3, Peter G Blake4,5, Rajnish Mehrotra2
1Northwest Kidney Centers, Seattle, Washington.
Clinical Journal of the American Society of Nephrology : CJASN
|September 7, 2023
Summary
Home dialysis offers independence and flexibility, but its use is limited by system barriers. Policy and advocacy are crucial for improving home dialysis quality and accessibility for kidney patients.
Area of Science:
- Nephrology
- Healthcare Policy
- Patient Advocacy
Background:
- Home dialysis is recognized for patient independence and flexibility.
- Despite benefits, home dialysis use remains low in the US.
- Systemic barriers hinder home dialysis growth.
Purpose of the Study:
- Outline trends in home dialysis utilization.
- Review quality of care standards for home dialysis patients.
- Discuss policy and advocacy efforts impacting home dialysis.
Main Methods:
- Analysis of home dialysis use trends.
- Review of quality of care metrics.
- Examination of policy and advocacy initiatives.
- International comparative analysis.
Main Results:
- Home dialysis adoption is suboptimal due to infrastructure, staffing, patient, and physician barriers.
- Evolving understanding of high-quality home dialysis care is presented.
- Policy and advocacy efforts are shaping US home dialysis care.
Conclusions:
- Addressing system-level factors is essential for expanding home dialysis.
- Continued focus on quality measurement and advocacy is needed.
- International comparisons offer insights for US improvement.
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