High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System

**Background:** The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. **Objectives:** T...

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Main Authors: J. Mark Stephens, Samuel Brotherton, Stephan C. Dunning, Larry C. Emerson, David T. Gilbertson, Matthew Gitlin, Ann C. McClellan, William M. McClellan, Sanatan Shreay
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2013-08-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/9861
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author J. Mark Stephens
Samuel Brotherton
Stephan C. Dunning
Larry C. Emerson
David T. Gilbertson
Matthew Gitlin
Ann C. McClellan
William M. McClellan
Sanatan Shreay
author_facet J. Mark Stephens
Samuel Brotherton
Stephan C. Dunning
Larry C. Emerson
David T. Gilbertson
Matthew Gitlin
Ann C. McClellan
William M. McClellan
Sanatan Shreay
author_sort J. Mark Stephens
collection DOAJ
description **Background:** The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. **Objectives:** To estimate US dialysis transportation costs from a purchaser’s perspective, and to estimate cost savings that could be achieved if less expensive means of transport were utilized. **Methods:** Costs were estimated using an actuarial model. Travel distance estimates were calculated using GIS software from patient ZIP codes and dialysis facility addresses. Cost and utilization estimates were derived from fee schedules, government reports, transportation websites and peer-reviewed literature. **Results:** The estimated annual cost of dialysis transportation in the United States is $3.0 billion, half of which is for ambulances. Most other costs are due to transport via ambulettes, wheelchair vans and taxis. Approximately 5% of costs incurred are for private vehicle or public transportation use. If ambulance use dropped to 1% of trips from the current 5%, costs could be reduced by one-third. **Conclusions:** Decision-makers should consider policies to reduce ambulance use, while providing appropriate levels of care.
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spelling doaj-art-fc3ba112f35f413d86a1b829990645ae2025-02-10T16:12:43ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362013-08-0112High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery SystemJ. Mark StephensSamuel BrothertonStephan C. DunningLarry C. EmersonDavid T. GilbertsonMatthew GitlinAnn C. McClellanWilliam M. McClellanSanatan Shreay**Background:** The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. **Objectives:** To estimate US dialysis transportation costs from a purchaser’s perspective, and to estimate cost savings that could be achieved if less expensive means of transport were utilized. **Methods:** Costs were estimated using an actuarial model. Travel distance estimates were calculated using GIS software from patient ZIP codes and dialysis facility addresses. Cost and utilization estimates were derived from fee schedules, government reports, transportation websites and peer-reviewed literature. **Results:** The estimated annual cost of dialysis transportation in the United States is $3.0 billion, half of which is for ambulances. Most other costs are due to transport via ambulettes, wheelchair vans and taxis. Approximately 5% of costs incurred are for private vehicle or public transportation use. If ambulance use dropped to 1% of trips from the current 5%, costs could be reduced by one-third. **Conclusions:** Decision-makers should consider policies to reduce ambulance use, while providing appropriate levels of care.https://doi.org/10.36469/9861
spellingShingle J. Mark Stephens
Samuel Brotherton
Stephan C. Dunning
Larry C. Emerson
David T. Gilbertson
Matthew Gitlin
Ann C. McClellan
William M. McClellan
Sanatan Shreay
High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
Journal of Health Economics and Outcomes Research
title High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_full High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_fullStr High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_full_unstemmed High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_short High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System
title_sort high costs of dialysis transportation in the united states exploring approaches to a more cost effective delivery system
url https://doi.org/10.36469/9861
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