Title Kidney failure and the federal government / Committee for the Study of the Medicare End-Stage Renal Disease Program, Division of Health Care Services, Institute of Medicine ; Richard A. Rettig and Norman G. Levinsky, editors

Published Washington, D.C. : National Academy Press, 1991

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Description 1 online resource (xiv, 426 pages) : illustrations, charts Contents ""Kidney Failure and the Federal Government""; ""Copyright""; ""Acknowledgments""; ""Contents""; ""PART I Overview""; ""Summary""; ""THE CONGRESSIONAL CHARGE TO THE INSTITUTE OF MEDICINE""; ""BASIC ASSUMPTIONS""; ""ESRD PATIENTS AND THEIR TREATMENT""; ""ACCESS""; ""ETHICS""; ""THE PROVIDER COMMUNITY""; ""REIMBURSEMENT AND QUALITY""; ""Reimbursement Effects on Quality""; ""Outpatient Dialysis Reimbursement Issues""; ""Covered Services""; ""Rate-Setting and Payment Policy""; ""QUALITY ASSESSMENT AND ASSURANCE""; ""DATA SYSTEMS""; ""RESEARCH""; ""NOTES""; ""REFERENCES""; ""1 Introduction"" ""THE CONGRESSIONAL CHARGE""""BASIC ASSUMPTIONS""; ""CONTEXT OF THIS STUDY""; ""STUDY METHODS""; ""THE ESRD PATIENT POPULATION""; ""NATIONAL EXPENDITURES FOR ESRD""; ""ORGANIZATION OF THE REPORT""; ""NOTES""; ""REFERENCES""; ""PART II Patients and Providers""; ""2 Perspectives of ESRD Patients""; ""EXPERIENCES WITH RENAL FAILURE""; ""Patient Relationships with Physicians and Staff""; ""Patient Education""; ""Patient-Related Services""; ""Effect of Erythropoietin""; ""ECONOMIC EFFECTS OF KIDNEY FAILURE""; ""CONCLUSIONS""; ""NOTE""; ""REFERENCE""; ""3 Ethical Issues"" ""PATIENT ACCEPTANCE CRITERIA""""WITHDRAWAL FROM TREATMENT""; ""Guidelines""; ""Advance Directives""; ""TREATING THE PROBLEM PATIENT""; ""CONCLUSIONS AND RECOMMENDATIONS.""; ""NOTES""; ""REFERENCES""; ""4 The Patient Population""; ""INCIDENCE AND PREVALENCE""; ""COMPOSITION OF THE ESRD POPULATION""; ""MORTALITY ISSUES""; ""Unadjusted Mortality""; ""Adjusted Mortality""; ""Subgroup Mortality""; ""STATE AND REGIONAL MORTALITY DATA""; ""CROSS-NATIONAL MORTALITY DATA""; ""PROJECTIONS TO THE YEAR 20006""; ""NOTES""; ""REFERENCES""; ""5 The ESRD Patient Population: Special Groups"" ""PEDIATRIC PATIENTS""""ELDERLY ESRD PATIENTS""; ""DIABETIC PATIENTS""; ""HYPERTENSIVE PATIENTS""; ""Hypertension in the United States""; ""Relationship Between Hypertension and Hypertensive ESRD""; ""Epidemiology of ESRD Attributed to Hypertension""; ""Intervention""; ""MINORITY PATIENTS""; ""CONCLUSION""; ""NOTES""; ""REFERENCES""; ""6 Structure of the Provider Community""; ""OVERVIEW""; ""Outpatient Dialysis Facilities""; ""Kidney Transplant Centers""; ""Pediatric Facilities""; ""CHANGING STRUCTURE OF THE OUTPATIENT DIALYSIS COMMUNITY""; ""Hospital-Based Versus Independent Providers9"" ""Hospital-Based Providers""""Patients""; ""Independent Providers""; ""Outpatient Dialysis Facilities""; ""Not-For-Profit Versus For-Profit Providers11""; ""Not-For-Profit Providers""; ""For-Profit Providers""; ""Size of Outpatient Dialysis Facilities12""; ""Facility Ownership""; ""CONCLUSIONS""; ""NOTES""; ""REFERENCES""; ""PART III Access""; ""7 Access Problems of ESRD Patients""; ""ESRD PATIENTS NOT ELIGIBLE FOR MEDICARE""; ""Who Are the Reported Noneligibles?""; ""Magnitude of the Problem""; ""Geographic Variations""; ""Payment Sources""; ""State Medicaid Programs"" Summary Overview -- Summary -- Introduction -- Patients and providers -- Perspectives of ESRD patients -- Ethical issues -- The patient population -- The ESRD patient population: special groups -- Structure of the provider community -- Access -- Access problems of ESRD patients -- Access to kidney transplantation -- Reimbursement and quality -- Medicare ESRD payment policy -- Reimbursement effects on quality -- Outpatient dialysis reimbursement issues -- Quality assessment and assurance -- Data and research -- Data systems -- Research needs 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 Bibliography Includes bibliographical references and index Notes Master and use copy. Digital master created according to Benchmark for Faithful Digital Reproductions of Monographs and Serials, Version 1. Digital Library Federation, December 2002. http://purl.oclc.org/DLF/benchrepro0212 MiAaHDL English Print version record digitized 2010 HathiTrust Digital Library committed to preserve pda MiAaHDL Subject United States. Medicare Bureau. End-Stage Renal Disease Program. SUBJECT United States. Medicare Bureau. End-Stage Renal Disease Program fast Subject Chronic renal failure -- Government policy -- United States Medicare. Medical policy. Sociology. Vital statistics. Social sciences. Urinary organs -- Diseases. Health services accessibility. Health behavior. Urinary organs. Patient compliance. Weights and measures. Non-governmental organizations. Adulthood. Insurance. Health planning. Surgery, Operative. National health services. Health services administration. Mathematics. Therapeutics. Social control. Medical care. Information storage and retrieval systems. Genitourinary organs -- Diseases. Public welfare. Demography. Human behavior. Physical sciences. Public health. Human rights. Genitourinary organs. Nursing care plans. Health attitudes. Philosophy. Diseases. Anatomy. Humanities. Children. Federal government. Kidneys -- Diseases. Mortality. Minorities. Quality of life. Economics. Statistics. Medical personnel. Kidneys. Chronic renal failure. Age factors in disease. Medicaid. Health facilities. Cost effectiveness. Hemodialysis. Patient refusal of treatment. Older people. Transplantation of organs, tissues, etc. Statistics -- Methodology Health Policy Kidney Failure, Chronic -- economics Kidney Failure, Chronic -- therapy Medicare -- economics Sociology Population Characteristics Legislation as Topic Jurisprudence Health Care Facilities, Manpower, and Services Vital Statistics Social Sciences Sorption Detoxification Age Groups Financing, Organized Social Control Policies Urologic Diseases Epidemiologic Methods Health Services Accessibility Epidemiologic Factors Renal Replacement Therapy Health Behavior Urinary Tract Medical Assistance Health Care Economics and Organizations Health Care Quality, Access, and Evaluation Renal Insufficiency, Chronic Costs and Cost Analysis Advance Care Planning Databases as Topic Patient Acceptance of Health Care Health Care Evaluation Mechanisms Patient Rights Weights and Measures Organizations Adult Occupational Groups Insurance Health Planning Surgical Procedures, Operative Health Services Health Services Administration Life Mathematics Therapeutics Patient Care Management North America Social Control, Formal Delivery of Health Care Information Systems Male Urogenital Diseases Public Assistance Investigative Techniques Data Collection Demography Anthropology, Education, Sociology and Social Phenomena Behavior Natural Science Disciplines Persons Public Health Policy Human Rights Americas Urogenital System Analytical, Diagnostic and Therapeutic Techniques and Equipment Patient Care Planning Renal Insufficiency Female Urogenital Diseases Attitude to Health Information Storage and Retrieval Philosophy Information Science Disciplines and Occupations Female Urogenital Diseases and Pregnancy Complications Medical Informatics Applications Epidemiologic Measurements Disease Environment and Public Health Geographic Locations Behavior and Behavior Mechanisms Named Groups Comprehensive Health Care Anatomy Humanities Medical Informatics Geographicals Psychiatry and Psychology Child Federal Government Kidney Diseases Mortality Advance Directives Databases, Factual Minority Groups Quality of Health Care Quality of Life Economics Fees and Charges Statistics as Topic Financial Support Health Personnel Kidney Kidney Failure, Chronic Withholding Treatment Age Factors Medicaid Patient Care Public Policy Health Facilities Medicare Morbidity Socioeconomic Factors Cost-Benefit Analysis Renal Dialysis Treatment Refusal Government Aged Reference Standards Resource Allocation Health Care Rationing Insurance, Health United States Financing, Government Organ Transplantation Transplantation sociology. social sciences. insurance. welfare services. demography. human behavior. physical sciences. public health. philosophy. anatomy. humanities. children (people by age group) federal government. mortality. minorities. quality of life. economics. health facilities. cost benefit analysis. governments (administrative bodies) elderly. federal aid. treating (health care function) statistics. HEALTH & FITNESS -- Health Care Issues. MEDICAL -- Public Health. MEDICAL -- Health Policy. HEALTH & FITNESS -- Diseases -- General. MEDICAL -- Diseases. MEDICAL -- Health Care Delivery. Chronic renal failure -- Government policy Medicare Nierinsufficiëntie. Behandelingsmethoden. SUBJECT United States Subject United States Form Electronic book Author Rettig, Richard A. Levinsky, Norman G. (Norman George), 1929- LC no. 91015611 ISBN 0585155607 9780585155609 1280203986 9781280203985 9786610203987 6610203989 0309597692 9780309597692

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