Benchmark for Dialysis and Healthcare Disparities in India

Context

Recently, A study published in the Medical Journal ‘Lancet’ establishes a national benchmark for dialysis success rate for the first time.

Benchmark for Dialysis: Key highlights of the Study 

• Paper(study) was led by: The study was led by Medical research institute George Institute of Global Health.
• Study Overview and Findings: 
  • A Benchmark for Dialysis Survival: 

• • • In a first national benchmark for survival among dialysis patients in India, revealed an estimate of raw survival rate of 71%. 
  • Based on the examination of 23,601 patients across 193 centres in 20 states, registered with NephroPlus centres (It  is the largest dialysis network in the country) between 2014-2019. 
    • 7 out of 10 patients survive beyond six months of dialysis treatment. 
    • While, 28% receiving hemodialysis died within 10 months
  • National vs Global Average: It highlights a mortality rate twice that of global averages. 
  • Factors Contributing to Survival Rates: Survival rates were influenced by various factors including dialysis vintage, vascular access type, and presence of diabetes and hypertension. 
  • Regional Disparities and Healthcare Access: 
    • Mortality Rate in Rural Vs Urban: 32% higher mortality rate in rural dialysis centers compared to urban centers. 
    • Out of Pocket Medical Expenses Vs Government Benefits & Insurance Cover: Patients who paid for their treatment out of pocket experienced higher mortality rates compared to those whose treatment was government-subsidized or covered by private insurance. 

Government Efforts to Dialysis

• Among all procedures covered under the Ayushman Bharat scheme, the government spends the most money on dialysis procedures. 
• Launch of National Dialysis Service: It was launched in 2016 to improve access to kidney replacement therapy and efforts to make dialysis affordable.
• Pradhan Mantri National Dialysis Programme: To provide free dialysis services to the Below poverty line people near to their district centres across the country.

Challenges and Recommendations

• Data Advocacy: Despite the increasing burden of chronic kidney disease, there is limited data available on clinical outcomes in India. 
• Extend coverage under the National Dialysis Service: To include prevention and long-term management of complications associated with dialysis. 
• Need to address unmeasured factors:  Unmeasured factors  such as access to transportation, medication, nutrition, and social support for dialysis patients which will reduce their Out of Pocket Expenditure & they can ensure a healthy lifestyle.

News Source: DTE

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