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Economics Of End-Stage Renal Disease Term Paper

ESRD patients provide the full fixed cost payment due to the full reimbursement for their care. Long-term care facilities would like to have 100% ESRD patients however, such a patient load does require skilled workers in numbers to care for these especially demanding patients. ESRD includes the ADL's and care specific to kidney cleaning and functioning, such as dialysis treatment either at home or at an outpatient facility. Additionally, some patients are brought in as in-patients at the hospital for ESRD treatment and some patients are admitted and remain admitted at a hospital until discharged. These patients either receive home care treatment, receive treatment at an outpatient facility, or are admitted to a long-term care facility.

Patient options & trade-offs related to cost, quality, and access to treatment

The patient has somewhat limited options as a function of the cost, quality, and access to health care. Largely, the options are dependent on the nature of health care services required by the patient. Additionally, the options are specific to the type of insurance coverage (if any) the patient is insured to receive.

For ESRD patients, the options available include Medicare & Medicaid coverage, which for ESRD will generally include Social Security Income benefits due to the End Stage Renal Disease provision. Nursing...

The cost of a nursing home can run into the thousands per month and if there is no coverage for services, patients are likely to pay out of pocket for services with no reimbursement.
Medicare/Medicaid coverage enables the least cost to the patient but provides potentially the lowest quality care with reasonable access to care. Private health care coverage is very expensive yet provides ostensibly the highest quality of care with limited access to care. However, the wealthy tend to have home care services, where health care specialists arrive onsite at the patient's residence to provide treatment.

Ethical implications of resulting treatment options based on cost evaluation

The ethical implications of seeking treatment options based on the cost criteria for health care services is to be considered. However, most of the developed world relies on a form of socialized medicine due to the need to provide access, coverage, and care to a large number of individuals. Ethically, the more noble cause is served at the cost of quality. Patients are always able to pay for higher quality care, but they will have to pay. Cost evaluation does leave many patients out in the cold, and without care. This ethical implication is the current problem with the U.S. health care delivery system.

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