Kidney Failure and the Federal Government

Since 1972, many victims of endstage renal disease (ESRD) have received treatment under a unique Medicare entitlement. This book presents a comprehensive analysis of the federal ESRD program: who uses it, how well it functions, and what improvements are needed. The book includes recommendations on patient eligibility, reimbursement, quality assessment, medical ethics, and research needs. Kidney Failure and the Federal Government offers a wealth of information on these and other topics: The ESRD patient population. Dialysis and transplantation providers. Issues of patient access and availability of treatment. Ethical issues related to treatment initiation and termination. Payment policies and their relationship to quality of care. This book will have a major impact on the future of the ESRD program and will be of interest to health policymakers, nephrologists and other individual providers, treatment site administrators, and researchers. Table of ContentsFront MatterPart I: Overview, SummaryIntroductionPart II: Patients and Providers, Perspectives of ESRD PatientsEthical IssuesThe Patient PopulationThe ESRD Patient Population: Special GroupsStructure of the Provider CommunityPart III: Access, Access Problems of ESRD PatientsAccess to Kidney TransplantationPart IV: Reimbursement and Quality, Medicare ESRD Payment PolicyReimbusement Effects on QualityOutpatient Dialysis Reimbursement IssuesQuality Assessment and AssurancePart V: Data and Research, Data SystemsResearch NeedsAppendix A: GlossaryAppendix B: Acronyms and InitialismsAppendix C: Commissioned Papers and Contractor ReportsAppendix D: Survival Analysis Methods for the End-Stage Renal Disease (ESRD) Program of MedicareAppendix E: Institute of Medicine ESRD Study Committee Public Hearing, May 5, 1989, Chicago, IllinoisAppendix F: Institute of Medicine ESRD Study Committee Public Hearing onAppendix G: Institute of Medicine ESRD Study Committee Workshop on ESRD Staffing, November 3, 1989, Washington, D.C.Appendix H: Institute of Medicine ESRD Study Committee Workshop on Kidney Transplantation, December 13, 1989, Washington, D.C.Appendix I: Institute of Medicine ESRD Study Committee Workshop on Black and Other Nonwhite ESRD Patients, May 15, 1990, Washington, D.C.Appendix J: Institute of Medicine ESRD Study Committee ESRD Patient Focus-Group ParticipantsIndex