In India, almost 200,000 patients require dialysis every year, and it is estimated that less than 30 per cent of them manage to receive this life-saving therapy due to unavailability or high cost says a study.
Efforts to provide dialysis to those suffering advanced kidney disease should be combined with more cost-effective efforts while maintaining quality and safety, the paper published by Lancet journal says.
There is also a requirement that regulations introduced for upkeep of standards are maintained according to lead author of the paper Vivekanand Jha, Executive Director of the George Institute for Global Health in New Delhi.
He added that audit systems should be designed to facilitate and encourage documentation of patient care and transparent reporting of costs and outcomes of care to provide an evidence decision making and objective performance evaluation.
The paper entitled ‘Ethical issues in dialysis therapy’ argues that health systems should establish programs of kidney disease prevention and health promotion together with dialysis and transplantation initiatives.
Health professionals and policy makers have been encouraged to reduce dialysis costs using simple, safe and affordable measures without compromising quality of therapy.
The study says that major ethical, practical and economic challenges for health-care systems arise in this process including increasing access to dialysis, helping patients and families to make the best decisions of managing kidney failure and ensuring that patients receive affordable high quality chronic dialysis based on global standards.
Dialysis access criteria and policy must be combined with an understanding of broader access issues concerning prevention and management of chronic kidney disease, supportive care and management of complications that may arise.
Physicians should it says provide information about risk and benefits of dialysis and support to patients or their surrogate decision makers in treatment options other co-authors said.
Its been estimated by Lancet that in 2015, an estimated 2.28 million patients died in 2010 being unable to afford treatment. Many of them were from low-income and lower-middle income countries it concluded.