In the U.S., most patients with ESRD are treated with hemodialysis, which must be done in a hospital three times per week, compared to peritoneal dialysis, which can be done by the patient at home. PD has a higher risk of infection and is avoided in the U.S. due to concern regarding patients’ access to physicians for monitoring; however, the cost of PD is significantly less ($130,000 in the U.S.) compared to nearly HD treatment ($174,000), according to 2009 article in the Journal of Managed Care.
However, Professor Govindarajan cites a program at Lazarus Hospital in India that treats rural ESRD patients with PD for just $12,000 using remote monitoring. For these rural patients, the program uses text messaging, digital cameras and the internet to facilitate monitoring and augmented home visit protocol on a regular basis. A recent analysis of these patients by the hospital found they had higher survival rates than urban ESRD patients, according to the article.
While labor and supply costs are lower overall in India, Professor Govindarajan believes using PD with remote monitoring to reduce concerns over access could present a significant opportunity for savings for the U.S. healthcare delivery system.
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