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Evaluation of disease-state management of dialysis patients.

Publication ,  Journal Article
Nissenson, AR; Collins, AJ; Dickmeyer, J; Litchfield, T; Mattern, W; McMahill, CN; Muhlbaier, L; Nielsen, J; Owen, WF; Pereira, BJ; Szczech, L ...
Published in: Am J Kidney Dis
May 2001

Dialysis patients are the only Medicare beneficiaries prohibited from joining managed care plans. Concerns have been raised about the ability of such plans to provide the comprehensive care required by patients with this complex condition. However, more than 20,000 dialysis patients belong to such plans because they were enrolled before developing end-stage renal disease (ESRD). Disease-state management, successfully applied to patients with diabetes mellitus and congestive heart failure, is now being used in patients with ESRD. Standardized mortality ratios (SMRs) and standardized hospitalization ratios (SHRs) were calculated for 1998 and 1999 in 1,541 patients enrolled in the RMS Disease Management program of renal disease-state management using US Renal Data System methods. SMRs were 0.643 and 0.806 for 1998 and 1999, respectively, significantly different from 1.0 for both years (P < 0.001). SHRs were 0.620 and 0.503 for 1998 and 1999, respectively, significantly different from 1.0 for both years (P < 0.001). Although additional studies are needed to define the aspects of care that are most important for the outcomes seen, this study shows that favorable outcomes are achievable for this vulnerable patient population within a managed care setting that applies coordinated approaches to care.

Duke Scholars

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

May 2001

Volume

37

Issue

5

Start / End Page

938 / 944

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Treatment Outcome
  • Sensitivity and Specificity
  • Renal Dialysis
  • Middle Aged
  • Medicare
  • Male
  • Kidney Failure, Chronic
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nissenson, A. R., Collins, A. J., Dickmeyer, J., Litchfield, T., Mattern, W., McMahill, C. N., … Medical Advisory Board, RMS Disease Management, Inc, . (2001). Evaluation of disease-state management of dialysis patients. Am J Kidney Dis, 37(5), 938–944. https://doi.org/10.1016/s0272-6386(05)80009-5
Nissenson, A. R., A. J. Collins, J. Dickmeyer, T. Litchfield, W. Mattern, C. N. McMahill, L. Muhlbaier, et al. “Evaluation of disease-state management of dialysis patients.Am J Kidney Dis 37, no. 5 (May 2001): 938–44. https://doi.org/10.1016/s0272-6386(05)80009-5.
Nissenson AR, Collins AJ, Dickmeyer J, Litchfield T, Mattern W, McMahill CN, et al. Evaluation of disease-state management of dialysis patients. Am J Kidney Dis. 2001 May;37(5):938–44.
Nissenson, A. R., et al. “Evaluation of disease-state management of dialysis patients.Am J Kidney Dis, vol. 37, no. 5, May 2001, pp. 938–44. Pubmed, doi:10.1016/s0272-6386(05)80009-5.
Nissenson AR, Collins AJ, Dickmeyer J, Litchfield T, Mattern W, McMahill CN, Muhlbaier L, Nielsen J, Owen WF, Pereira BJ, Steinman TI, Szczech L, Medical Advisory Board, RMS Disease Management, Inc. Evaluation of disease-state management of dialysis patients. Am J Kidney Dis. 2001 May;37(5):938–944.
Journal cover image

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

May 2001

Volume

37

Issue

5

Start / End Page

938 / 944

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Treatment Outcome
  • Sensitivity and Specificity
  • Renal Dialysis
  • Middle Aged
  • Medicare
  • Male
  • Kidney Failure, Chronic
  • Humans