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Palliative Care Disincentives in CKD: Changing Policy to Improve CKD Care
- Source :
- American Journal of Kidney Diseases. 71:866-873
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- The dominant health delivery model for advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States, which focuses on provision of dialysis, is ill-equipped to address many of the needs of seriously ill patients. Although palliative care may address some of these gaps in care, its integration into advanced CKD care has been suboptimal due to several health system barriers. These barriers include uneven access to specialty palliative care services, under-developed models of care for seriously ill patients with advanced CKD, and misaligned policy incentives. This article reviews policies that affect the delivery of palliative care for this population, discusses reforms that could address disincentives to palliative care, identifies quality measurement issues for palliative care for individuals with advanced CKD and ESRD, and considers potential pitfalls in the implementation of new models of integrated palliative care. Reforming healthcare delivery in ways that remove policy disincentives to palliative care for patients with advanced CKD and ESRD will fill a critical gap in care.
- Subjects :
- Male
Advance care planning
medicine.medical_specialty
Palliative care
Population
030232 urology & nephrology
Specialty
Disease
urologic and male genital diseases
Article
Advance Care Planning
03 medical and health sciences
0302 clinical medicine
Quality of life (healthcare)
Renal Dialysis
medicine
Humans
030212 general & internal medicine
Renal Insufficiency, Chronic
Policy Making
Intensive care medicine
education
Health policy
education.field_of_study
business.industry
Health Policy
Palliative Care
medicine.disease
Quality Improvement
United States
female genital diseases and pregnancy complications
Hospice Care
Treatment Outcome
Nephrology
Kidney Failure, Chronic
Female
business
Delivery of Health Care
Kidney disease
Subjects
Details
- ISSN :
- 02726386
- Volume :
- 71
- Database :
- OpenAIRE
- Journal :
- American Journal of Kidney Diseases
- Accession number :
- edsair.doi.dedup.....a1dcb3a6d5f0b1f65fefe0d2c1beb41e
- Full Text :
- https://doi.org/10.1053/j.ajkd.2017.12.017