Dialysis Treatment Options There are limited dialysis treatment options in the United States – for those patients who are unable to get a kidney transplant they have one of two options: Hemodialysis and peritoneal dialysis. Hemodialysis is a service that is conducted at an outpatient centre in most cases with patients visiting the center up to 3 times per week for 3 – 4.5 hours at a time (Sullivan, 2010). Despite some research indicating that patients could go for shorter periods of time on a daily basis, because the reimbursement structure is based on the three times per week model it is likely to stay that way (Saran et al 2006). Peritoneal dialysis is very different. The patient is dialyzed through a catheter that is put into the lower abdomen and this sends the dialysis fluid directly into the peritoneal cavity. There are two types of peritoneal dialysis available – Continuous Ambulatory Peritoneal Dialysis and Continuous Cycling Peritoneal Analysis (Sullivan, 2006). Treatment is provided every day although the reimbursement for this treatment is still being paid for three treatments per week as with the hemodialysis treatment. The major advantage of peritoneal dialysis over hemodialysis is that the treatment is flexible with the CCPD model done while the patient sleeps. However the risk of infection is more prevalent in patients who use the peritoneal dialysis model. Studies have shown that patients who are on the peritoneal dialysis model are likely to be healthier, have a greater kidney function and be less likely to have external treatments for other issues such as anemia (Snyder et al., 2004). Most of the providers of dialysis are for-profit companies and Fresenius Medical Care is one of the largest (Sullivan, 2010). Fresenius and their largest competitor in the US, DaVita, control 82 % of the top ten providers; the remaining 18% is taken up by smaller niche clinics. Fresenius is an integrated company that not only provides the dialysis care but they also manufacture the machinery and supplies needed as well. Worldwide Fresenuis has the largest patient base than any other provider. It is the bigger companies like Fresenius that have been able to stay solvent in the face of Medicare’s unwillingness to raise the composite rate. Larger companies have some leverage with the economies of scale but they are also able to leverage their payments from commercial insurance providers who make up the shortfall that stems from Medicare and Medicaid patients. Client Experiences – Costs and Access Analysis Clients experience what Fresenius has to offer usually through one of Fresenius’s partner hospitals or dialysis clinic. Hemodialysis units are very expensive which is why some outpatient dialysis clinics can cost more than $2 million to get set up (Sullivan, 2006). To leverage those fixed costs for-profit dialysis centers (like those set up through Fresenius’s company) have more patients using the one unit than non-profit and hospital centers. Sullivan (2010) suggested that from a company standpoint the peritoneal dialysis treatment does work out a lot more cost effective in terms of fixed costs. There is no need to have the overheads required in a dialysis clinic and while training and labor are still important factors they are less expensive in the long term than investment in the machinery required for hemodialysis units. From a patient perspective though, the medical supply costs are
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Experiential Analysis: Fresenius Experiential Analysis: Fresenius The Fresenius Medical Care is a global company that is focused on patient orientated renal therapy. In the United States the Medical Care arm of the company provides dialysis products and services that cater for nearly 138,000 patients…
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