A multi-centre observational study of how financial considerations influence dialysis treatment decisions

Introduction Little is known about the factors that contribute to the successful uptake of home dialysis, although increased utility costs have been identified as one possible factor affecting the decision to take up home dialysis. This paper reports on quantitative survey data collected during an Australian multi-centre observational study that aimed to identify factors that either facilitate or inhibit the uptake of home dialysis from patients' perspectives. Method This paper provides a quantitative analysis of survey responses that dealt with the question of how cost is experienced by those on dialysis, whether home or hospital. 138 participants were recruited from five dialysis centres. All forms of dialysis treatment were included. The survey was purposely designed to gain insight into how home dialysis is perceived and/or experienced. Survey responses were counted, ranked and summarised. Result Quantitative measures reported in this paper identify obstacles and facilitators to home dialysis. While costs were a concern for some home dialysis patients, cost alone did not explain treatment decisions. Support and medical advice were reported as more common factors affecting treatment decisions. Discussion & Conclusion The quantitative analysis of results shown in this paper indicates that cost does not determine treatment decisions for these dialysis patients in Australia. This finding lends support to at least maintaining the financial support offered to Australian patients as they prepare for home dialysis. Ongoing costs were documented and the results shown here provide justification for additional assistance in the form of payouts to dialysis patients on low incomes

Identifying factors associated with the uptake of home dialysis : observational study methodology

Background: The use of home dialysis has been declining in Australia, despite the considerable advantages for patients. Little is known about the factors that contribute to the successful uptake of home dialysis, although increased utility costs have been identified as one possible factor affecting the decision to take up home dialysis. Objectives: This Australian multicentre observational study will identify factors that either facilitate or inhibit the uptake of home dialysis from patients' perspectives, including the evaluation of whether the current levels of financial support impacts on their decision. Design: Factors influencing decisions about home or hospital dialysis will be explored from the patients' perspective through survey and interviews. Initially, participants will be recruited from participating dialysis centres and invited to complete a survey. Staff will collect clinical data for all those participating. A subsection of patients will be invited to participate in an individual interview or focus group to gather more information. Participants: Participants will be recruited from dialysis centres affiliated with the HOME Network, a national initiative to engage health care professionals in the field of home dialysis. Measurements: Combining the analysis of individual and group data that is both reported and observed will offer an in-depth understanding of patients' perception of home dialysis that will inform policy and practice at both participating centres and in the broader clinical community.6 page(s

Identifying factors associated with the uptake of home dialysis : observatonal study methodology

Background:: The use of home dialysis has been declining in Australia, despite the considerable advantages for patients. Little is known about the factors that contribute to the successful uptake of home dialysis, although increased utility costs have been identified as one possible factor affecting the decision to take up home dialysis. Objectives: This Australian multicentre observational study will identify factors that either facilitate or inhibit the uptake of home dialysis from patients' perspectives, including the evaluation of whether the current levels of financial support impacts on their decision. Design: Factors influencing decisions about home or hospital dialysis will be explored from the patients' perspective through survey and interviews. Initially, participants will be recruited from participating dialysis centres and invited to complete a survey. Staff will collect clinical data for all those participating. A subsection of patients will be invited to participate in an individual interview or focus group to gather more information. Participants: Participants will be recruited from dialysis centres affiliated with the HOME Network, a national initiative to engage health care professionals in the field of home dialysis. Measurements: Combining the analysis of individual and group data that is both reported and observed will offer an in-depth understanding of patients' perception of home dialysis that will inform policy and practice at both participating centres and in the broader clinical community. Results: Results obtained will serve as a platform for further research of this relatively unexplored topic