title: A Global Overview of the Impact of Peritoneal Dialysis First or Favored Policies: An Opinion.
abstract: Given the ever-increasing burden of end-stage renal disease (ESRD) in a global milieu of limited financial and health resources, interested parties continue to search for ways to optimize dialysis access. Government and payer initiatives to increase access to renal replacement therapies (RRTs), particularly peritoneal dialysis (PD) and hemodialysis (HD), may have meaningful impacts from clinical and health-economic perspectives; and despite similar clinical and humanistic outcomes between the two dialysis modalities, PD may be the more convenient and resource-conscious option. This review assessed country-specific PD-First/Favored policies and their associated background, implementation, and outcomes. It was found that barriers to policy-implementation are broadly associated with government policy, economics, provider or healthcare professional education, modality-related factors, and patient-related factors. Notably, the success of a given country's PD-Favored policy was inversely associated with the extent of HD infrastructure. It is hoped that this review will provide a foundation across countries to share lessons learned during the development and implementation of PD-First/Favored policies.
authors.affiliation: Baxter Healthcare Corporation, Deerfield, IL, USA Xiaoqing_liu@baxter.com.
authors.forename: Frank Xiaoqing
authors.initials: FX
authors.lastname: Liu
authors.affiliation: Pharmerit International, Bethesda, MD, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
authors.affiliation: Hollister Incorporated, Libertyville, IL, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Inglese
authors.affiliation: Banphaeo Hospital, Prommitr branch, Bangkok, Thailand.
authors.forename: Piyatida
authors.initials: P
authors.lastname: Chuengsaman
authors.affiliation: Pontificia Universidade Católica do Paraná, School of Medicine, Curitiba, Parana, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
authors.affiliation: Hong Kong Baptist Hospital, Hong Kong, China.
authors.forename: Alex
authors.initials: A
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D014943:Global Health; D006291:Health Policy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D011050:Policy Making; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
keywords: Peritoneal dialysis; global overview; peritoneal dialysis favored policy; peritoneal dialysis first policy
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