O.R. model could reduce high death rate among kidney dialysis patients by up to 20%

An operations research model for centers that treat kidney dialysis patients could reduce America's high mortality rate for those with the disease while containing budget costs, according to a study published in a journal of the Institute for Operations Research and the Management Sciences (INFORMS).

"Dynamic policies that adjust dialysis based on the kind and number of patients a center can handle have the potential to improve life expectancy, in some cases by as much as 20%," says Stefanos A. Zenios of Stanford University. Another way of applying these models would allow centers to reduce the financial burden of operation by as much as 10% while maintaining a constant level of care.

The study, "Managing the Delivery of Dialysis Therapy: A Multiclass Fluid Model Analysis," is by Professor Zenios, Graduate School of Business, Stanford University, and Prashant C. Fuloria, Closed Loop Solutions of Mountain View, California. It appears in the recently issued Vol. 46, No. 10 of Management Science, an INFORMS publication.

Rising Health Care Costs
The annual death rate for American patients with End Stage Renal Disease (ESRD) is 20 - 25%, double the rate in European countries. Experts suggest two explanations for the higher mortality rate: one, the larger number of critically ill patients accepted for treatment in the US compared to Europe; and, two, an American dialysis reimbursement rate that is 50% lower.

The reimbursement rate reflects the high cost of dialysis therapy. In the U.S., Medicare's ESRD program covers 90% of ESRD-related expenses. The program, which began in 1973 covering 10,000 patients, now covers more than 240,000 patients and has an annual budget of over $9 billion. There are pressures to contain the rising expense.

The authors' model addresses the need of two groups: physicians who prescribe dialysis for patients and kidney dialysis centers, which are strongly affected by budget pressures.

The model is a decision sup

Contact: Barry List
Institute for Operations Research and the Management Sciences

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