Early Delays in Insurance Coverage and Long-term Use of Home-based Peritoneal Dialysis.

ABSTRACT:

Background

Uninsured patients with end-stage renal disease face barriers to peritoneal dialysis (PD), a type of home dialysis that is associated with improved quality of life and reduced Medicare costs. Although uninsured patients using PD at dialysis start receive retroactive Medicare coverage for required predialysis services, coverage only applies for the calendar month of dialysis start. Thus, initiating dialysis later in the month yields longer retroactive coverage.

Objectives

To examine whether differences in retroactive Medicare were associated with decreased long-term PD use.

Research design

We exploited the dialysis start date using a regression discontinuity design on a national cohort from the US Renal Data System.

Subjects

36,256 uninsured adults st

SUBMITTER: Lin E 

PROVIDER: S-EPMC7295012 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature