title: To survive is not enough. Quality of life in CKD--the need for a new generation of health-oriented economists.
abstract: CKD is utilized as a paradigm, a chronic disease which allows decades of life conquered with great effort through a machine, a life with many losses and many dependencies. We must understand the patient's needs, which are not related to availability of drugs and machines and hospitals. We cannot provide good medical care with the limited amount of national product devoted to health care. Society is much older than ever before. We need a new cadre of economists working on health care with vision and ability, keeping in mind that there are no resources and there are no expenses which can be cut in medical care nowadays. We have to switch from curative medicine towards prevention, by implementing clinical research, bearing in mind that in the Western world, democracy was granted through the correct allocation of resources. The search for happiness and good quality of life are old concepts born in the Mediterranean area over the centuries, starting with Hesiod and Homer, and sleep and dreams were being investigated centuries before Freud was born.
authors.affiliation: First Division of Nephrology, Second University of Naples, Via Pansini 5, Naples, Italy. nataleg.desanto@unina2.it
authors.forename: Natale G
authors.initials: NG
authors.lastname: De Santo
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: De Santo
authors.forename: Alessandra F
authors.initials: AF
authors.lastname: Perna
authors.forename: Pietro
authors.initials: P
authors.lastname: Anastasio
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bilancio
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Pollastro
authors.forename: Vito A
authors.initials: VA
authors.lastname: Di Leo
authors.forename: Massimo
authors.initials: M
authors.lastname: Cirillo
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D035843:Biomedical Research / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004325:Dreams; D014943:Global Health; D017048:Health Care Costs / Q000331:legislation & jurisprudence; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics; D049690:History, Ancient; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007558:Italy; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D018803:Models, Economic; D010686:Philosophy, Medical / Q000266:history; D010817:Physician-Patient Relations; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics* / Q000523:psychology; D012109:Research Support as Topic; D040841:Resource Allocation / Q000191:economics* / Q000331:legislation & jurisprudence; D012890:Sleep; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome