Evidence map›Paper›PMID 27196634›Full record

ArticleHemodialysis international. International Symposium on Home Hemodialysis2016

The economic considerations of patients and caregivers in choice of dialysis modality.

Rachael C Walker, Kirsten Howard, Allison Tong, Suetonia C Palmer, Mark R Marshall, Rachael L Morton

Abstract read
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In one paragraph

Article in Hemodialysis international. International Symposium on Home Hemodialysis, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. A Systematic Review of the Qualitative Research on Barriers and Facilitators to Home Hemodialysis.Hemodialysis international. International Symposium on Home Hemodialysis · 2025
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  5. Non-medical barriers reported by nephrologists when providing renal replacement therapy or comprehensive conservative management to end-stage kidney disease patients: a systematic review.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rachael C WalkerSydney School of Public Health, University of Sydney, Sydney, New South Wales, 2006, Australia. rachaelwalker14@gmail.com.
Kirsten HowardSydney School of Public Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
Allison TongSydney School of Public Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
Suetonia C PalmerDepartment of Medicine, University of Otago, Christchurch, 8140, New Zealand.
Mark R MarshallBaxter Healthcare, (Asia- Pacific), Shanghai, China.
Rachael L MortonNHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, 2006, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Broader adoption of home dialysis could lead to considerable cost savings for health services. Globally, however, uptake remains low. The aim of this study was to describe patient and caregiver perspectives of the economic considerations that influence dialysis modality choice, and elicit policy-relevant recommendations. Methods Semistructured interviews with predialysis or dialysis patients and their caregivers, at three hospitals in New Zealand. Interview transcripts were analyzed thematically. Findings 43 patients and 9 caregivers (total n = 52) participated. The three themes related to economic considerations were: (i) productivity losses associated with changes in employment; (ii) the need for personal subsidization of home dialysis expenses; and (iii) the role of socio-economic disadvantage as a barrier to home dialysis. Patients weighed the flexibility of home dialysis which allowed them to remain employed, against time required for training and out-of-pocket costs. Patients saw the lack of reimbursement of home dialysis costs as unjust and suggested that reimbursement would incentivize home dialysis uptake. Social disadvantage was a barrier to home dialysis as patients' housing was often unsuitable; they could not afford the additional treatment costs. Home hemodialysis was considered to have the highest out-of-pocket costs and was sometimes avoided for this reason. Discussion Our data suggests that economic considerations underpin the choices patients make about dialysis treatments, however these are rarely reported. To promote home dialysis, strategies to improve employment retention and housing, and to minimize out-of-pocket costs, need to be addressed directly by healthcare providers and payers.

Indexed as

AdultCaregiversFemaleHemodialysis, HomeHumansMaleRenal DialysisdialysiseconomicsincentivesKidney diseaseopportunity costqualitative researchreimbursement

Identifiers

PMID27196634
PMCPMC5324572

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.