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Since 1972, many victims of endstage renal disease (ESRD) have received treatment under a unique Medicare entitlement. This book presents a comprehensive analysis of the federal ESRD program: who uses it, how well it functions, and what improvements are needed.

The book includes recommendations on patient eligibility, reimbursement, quality assessment, medical ethics, and research needs.

Kidney Failure and the Federal Government offers a wealth of information on these and other topics:

  • The ESRD patient population.
  • Dialysis and transplantation providers.
  • Issues of patient access and availability of treatment.
  • Ethical issues related to treatment initiation and termination.
  • Payment policies and their relationship to quality of care.

This book will have a major impact on the future of the ESRD program and will be of interest to health policymakers, nephrologists and other individual providers, treatment site administrators, and researchers.

Suggested Citation

Institute of Medicine. 1991. Kidney Failure and the Federal Government. Washington, DC: The National Academies Press.

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Publication Info

440 pages | 6 x 9 | Hardcover
ISBN: 978-0-309-04432-5
Chapters skim
Front Matter i-xiv
Part I: Overview, Summary 1-22
Introduction 23-36
Part II: Patients and Providers, Perspectives of ESRD Patients 37-50
Ethical Issues 51-61
The Patient Population 62-84
The ESRD Patient Population: Special Groups 85-109
Structure of the Provider Community 110-132
Part III: Access, Access Problems of ESRD Patients 133-166
Access to Kidney Transplantation 167-188
Part IV: Reimbursement and Quality, Medicare ESRD Payment Policy 189-211
Reimbusement Effects on Quality 212-235
Outpatient Dialysis Reimbursement Issues 236-273
Quality Assessment and Assurance 274-312
Part V: Data and Research, Data Systems 313-327
Research Needs 328-334
Appendix A: Glossary 335-346
Appendix B: Acronyms and Initialisms 347-350
Appendix C: Commissioned Papers and Contractor Reports 351-352
Appendix D: Survival Analysis Methods for the End-Stage Renal Disease (ESRD) Program of Medicare 353-400
Appendix E: Institute of Medicine ESRD Study Committee Public Hearing, May 5, 1989, Chicago, Illinois 401-402
Appendix F: Institute of Medicine ESRD Study Committee Public Hearing on 403-404
Appendix G: Institute of Medicine ESRD Study Committee Workshop on ESRD Staffing, November 3, 1989, Washington, D.C. 405-405
Appendix H: Institute of Medicine ESRD Study Committee Workshop on Kidney Transplantation, December 13, 1989, Washington, D.C. 406-407
Appendix I: Institute of Medicine ESRD Study Committee Workshop on Black and Other Nonwhite ESRD Patients, May 15, 1990, Washington, D.C. 408-408
Appendix J: Institute of Medicine ESRD Study Committee ESRD Patient Focus-Group Participants 409-410
Index 411-426

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