The Medicare End-Stage Renal Disease Program: A Report From the Institute of Medicine
Levinsky, Norman G.
Rettig, Richard A.
New England Journal of Medicine. 1991 Apr 18; 324(16): 1143-1148.
Since End-Stage Renal Disease (ESRD) patients became entitled to Medicare benefits in 1972, the program has extended treatment access to many thousands of kidney failure victims. Gradually increasing expenditures have led Congress to reevaluate the program. The Institute of Medicine has responded with a report, analyzing patient demographics, access problems, quality of care, and the effects of budget changes on quality of care. The report predicts that greater numbers of elderly, diabetic, hypertensive, and minority patients will seek treatment in the coming years, and urges that access to benefits be further extended to include non-Medicare U.S. citizens and resident aliens, with transplantation being encouraged over dialysis. The committee concludes that further cuts in the reimbursement system would harm the quality and access of treatment; that payment rates should be updated yearly; and that quality of care should be systematically monitored and measured through a comprehensive basic research program. (KIE abstract)
Age Factors; Aged; Biomedical Technologies; Disease; Data Banks; Economics; Evaluation; Evaluation Studies; Federal Government; Financial Support; Government; Government Financing; Harm; Health; Health Care; Health Care Delivery; Kidney Diseases; Kidneys; Life; Medicine; Morbidity; Mortality; Organ Transplantation; Patient Care; Patients; Prognosis; Quality of Life; Renal Dialysis; Research; Resource Allocation; Statistics; Tissue Transplantation; Transplant Recipients; Transplantation;
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