Dialysis Treatment Use and Costs Reported in VA Administrative Databases Technical rept. no. 17

摘要

Kidney dialysis is performed roughly 300,000 times per year at VA facilities nationwide. Dialysis is provided by VA staff and by contractors in a series of arrangements that varies by location and year. If it were used consistently across sites, the Decision Support System (DSS) would yield reliable estimates of the frequency, type, and cost of dialysis procedures. In practice, however, there is considerable variation in how sites have tracked and assigned costs to dialysis. As a result, relatively little is known about the cost of providing dialysis to VA patients. There are several reasons to assess and validate the cost of dialysis. First, managers must understand operational unit costs in order to make decisions about whether to provide dialysis care directly or through contractors. Both arrangements are used in all VISNs and at many if not all VA acute-care hospitals. Increasing or decreasing reliance on contractors may be important policy options for senior managers. Second, VA researchers need to know the cost of dialysis in order to properly determine the cost of inpatient stays and outpatient encounters, such as those occurring within Cooperative Studies Program trials. Third, charting the availability of VA data on dialysis will facilitate comparisons across VA facilities in the use and cost of dialysis treatments. In this report we review current VA data on dialysis procedures. The report ends with recommendations for researchers and policymakers.