Benchmark for Dialysis and Healthcare Disparities in India

18 Mar 2024

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: 
Dialysis: 

  • It is a medical treatment to help individuals with kidney failure filter waste and excess fluid from the blood.

Hemodialysis (HD-Water Dialysis): 

  • It requires an artificial kidney machine to filter blood at a dialysis centre. 
  • In it blood is filtered through a machine that acts like an artificial kidney &  is returned back into the body.

Peritoneal dialysis (PD-Blood Dialysis): 

  • It is the process in which the patient’s own blood lining of the abdomen acts as a filter
  • A solution composed primarily of salts and sugars is injected into the abdomen to facilitate filtration. 
      • 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.
Also Read: Kidney Transplant In India

News Source: DTE

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Designed as per recent trends of Prelims questions
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