We've found with a small patient census that non-reusable dialyzers can still bring in a profit. But at what number of patients should a free standing clinic consider going to re-use? I am not looking for advocates of either side of the issue to let emotions enter this discussion. This is a purely financial question. Is there a critical number of patients that should be considered?

chieftex,

We have used 60 as the cut-off. What kind of formula was used to come to that I have no idea.

Chuck

There are so many variables that enter the formula, that it needs to be looked at on a case by case basis. There is no cookbook answer. As one example, if space is at a premium, space that was used for reuse can be used for another station for treatments, thereby enhancing revenue. You need to set up your own template for testing the options. Good luck.

We have 200 + patients, don't re-use,no machines are older than 6 yrs., have built or re-modeled all units and have great outcomes. PLUS WE HAVE GREAT MARGINS. IMHO if
you have to go to re-use to turn a profit your CFO should be canned.

So much for the emotionaless responses. Thankfully I'm not the CFO and I don't have to worry about such things as being canned becuase of this particular issue. However, I hope you noted that I said "free standing clinic" not a Fresenius,Davita or other dialysis chain behemoth that can afford to manufacture their own dialyzers.

Dear Chieftex,

The smaller your facility is in patient census, the more important it is to reuse the dialyzers. Why? You simply don't have the numbers to make a profit without doing it. We have a small rural facility, which means that we receive a very low composite rate for our hemodialysis treatments from Medicare. Dialyzer reuse helps us to continue servicing our local dialysis patients. Furthermore, financials aside, it helps to evaluate the quality of the heparinization of your patients. It's a good dialyzer evaluation tool. You would be surprised how many reuse techs have improved the treatments of their facility by pointing out dialyzers which are not clearly well. Otherwise, these dialyzers would simply end up in the biohazard box and patients would continue to receive a fair to even poor dialysis treatment.

Sincerely,

Joe Atkins

If you do re-use, you'll need a good incoming flow of new patients to replace the ones dropping off from re-use complications. Economically speaking there's most likely some profit to be had in kickbacks from morticians and grave diggers, justifiably so since you are killing people. New ESRD patients grow at 15% per annum and re-use has 10% higher mortality than single use, so in that there's a healthy 5% margin for the ghouls who want a buck no matter what.

m micone,

I have been in dialysis for almost 25 years now and I can honestly say that if I was a patient knowing what I know and I was offered reuse, I would jump at the chance.

Making statements like yours in a public forum is irresponsible akin to shouting FIRE in a crowded theater.

Chuck

There's a big difference between being "in" dialysis or "on" dialysis. Imagine the contaminants available to the patient w/re-use. How about the FACT that renalin was never approved by the FDA for use in dialysis. Re-use benefits the clinic. It's an economic question, and the companies who do re-use are doing so for profit. Any claims that it's for the better health of the patient is bogus and insincere.

m micone,

There is no argument that reuse CAN save a facility money but stating that it is the only reason for doing it is as bad as saying that first use syndrome is the only reason that reuse is a good thing.

FACT : The FDA does not "APPROVE" ANYTHING, they only clear it for marketing. Peracetic acid is cleared as an "accessory to a medical device", which is exactly what it is.

FACT : Reuse reduces the production of c-reactive protiens and other inflammatory agents.

FACT : There are very good single use dialyzers available that cost under $10. Most reuse dialyzers cost $20+. Each time a dialyzer is reprocessed it adds aproximately $5 to its cost. You do the math and figure out how many times a dialyzer has to be reused before you are even at the break-even point of a single use dialyzer. While you are doing the math, notice that the more times a dialyzer is used, the cost savings decreases.

FACT : Two of the big chains manufacture their own dialyzers so they only cost them however much it costs to make them which I'm sure is less than the cost of doing reuse ($5).

Now a question for you : If reuse is only done to make a profit, why do non-profit companies do reuse also?

Chuck

[This message has been edited by Chuck W (edited 05-18-2004).]

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[This message has been edited by Gary Peterson (edited 05-27-2004).]

Gary,

In all seriousness, do you not think that being required to state your full name, city of residence and valid email address is an invasion of privacy? Inappropriate posting should be dealt with by the administration. Putting your email address, not to mention your full name and city of residence, on a public board is just asking for harrassment in my book. No disrespect intended, but it doesn't sound like a good idea to me. My recommendation is to require registration with the board prior to posting. If all registered users are required to have an active email account, administration can get ahold of them at any time to discuss board activities. I would think that anyone coming here to actually attempt to be a productive member of this board wouldn't have a problem with doing that.

[This message has been edited by GTSCSS (edited 06-03-2004).]

Matt,

I understand your concerns but I also understand the policy. The policy makes people accountable for what they say which keeps this forum reputable and professional, unlike a couple other forums that I know of.

Chuck

How about the FACT that renalin was never approved by the FDA for use in dialysis. Re-use benefits the clinic. It's an economic question, and the companies who do re-use are doing so for profit. Any claims that it's for the better health of the patient is bogus and insincere.

The above statement is not factual. This is the person that should have been admonished for posting to this board.

The fact that IP addresses are posted allows anyone to find the city where the person lives. So this is not really anonymous posting. I prefer to post to Boards that are only professionals. No patients. They only confuse the issues with unsupported statements. And when I post to these boards I also use my full name.

My personality does not allow me to let stupid statements go unchallenged. If you say something stupid, I probably am going to tell you so.

Though I am a patient, I certainly do more research, and most likely have a better education than the average participant on these boards. When participation gets censored, it violates the basic ideals of communication. Techs will flak re-use because that's the company policy. Administrators violate the code of ethics when they start patients on re-use by saying, "sign here."
Noone can deny that cost considerations effect patient care. It's sad that people on this board are so insecure about their knowledge and training that they would rather restrict debate than participate. That's how Rush Limbaugh wins arguments, and O'reilly, shout down any opposing views.