'Flexible' or 'lifestyle' dialysis: is this the way forward?
BACKGROUND
Despite the advent of two new dialysis options, nocturnal home haemodialysis and short daily haemodialysis, many units are yet to build them into the modalities on offer to end-stage renal failure patients. The reasons behind this inertia are complex but primarily include anxieties about workload, budgetary implications and outcome data.


METHODS
The Geelong dialysis programme, where both nocturnal home haemodialysis and short daily haemodialysis are offered, is compared with Australian and New Zealand national profiles.


RESULTS
Significant profile differences emerge when comparing sessions/week and h/week between the three groups. Most Australian (92.93%) and New Zealand (95.07%) haemodialysis patients dialyse for three sessions/week. This contrasts to Geelong where only 73.6% dialyse for three sessions/week. 18.8% of Geelong haemodialysis patients versus 1.8% (Australia) and 0.9% (New Zealand) dialyse for five or more sessions/week. Australia and New Zealand follow similar h/session patterns although more Australians (44.2%) dialyse for 4 h and fewer (24.2%) for 5 h than their New Zealand counterparts (39.6% and 29.8%, respectively), and few dialyse outside the 3.5-5 h window. In contrast, 6.7% of Geelong patients dialyse for 2-2.5 h/session versus Australia (0.9%) and New Zealand (0.2%). This represents the Geelong short daily dialysis programme. More Geelong patients (>15%) dialyse >/=8 h/week and represent the Geelong nocturnal home haemodialysis programme.


CONCLUSIONS
The flexible Geelong programme has been supported without exceeding the budget applied to a conventional dialysis programme with the same patient numbers.
Agar
John W M
JW
Renal Unit, The Geelong Hospital, Barwon Health, Geelong, Victoria, Australia.
Mahadevan
Kumar
K
Knight
Richard
R
Antonis
Michelle L
ML
Somerville
Christine A
CA
D001071:Appointments and Schedules; D001315:Australia; D017048:Health Care Costs; D006437:Hemodialysis, Home / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D008019:Life Style; D009520:New Zealand; D026684:Personal Autonomy