The Demand and Supply - Essay Example

Running Head: Demand and Supply The Demand and Supply For Dialysis in the United s Introduction “Health is wealth”. This is one of the oldest and most common saying which emphasize the value of good health. The irony of this is that despite ones adeptness in the health topic, there is absolutely no guarantee of perfect health in a lifetime. One of the reasons why health care institutions offer a variety of products and services is to cater to the multitude of needs of the diverse clientele. In doing so, health care organizations rely on the concept of demand and supply to maximize the availability of their products and services. Various studies have been conducted to formulate that about 45% of the US population is known to have one or more chronic illness and this illness account for 78% of all health care spending. (Managing Care for Adults with Chronic Conditions, 2002, par. 2) The percentage alone divulges relevant information on the sheer number of possible clients needing patient care. Patients with chronic illness such as arthritis, hypertension, diabetes, among others, have actual and potential learning needs. Chronic disorders can impair mobility and therefore “interfere with learning psychomotor skills as a result of decreased flexibility and dexterity of the fingers”. (Delaune & Ladner, 2006, 424) Other chronic illnesses such as diabetes require continuing education and monitoring of their health situation and their ability to take care of themselves. Diabetes required regular monitoring of levels of blood sugar which is affected by the nature of the patient’s diet and physical activity. Further, as averred by Daniels, Nosek & Nicoll (2007, 1833), “diabetes mellitus and hypertension are the two most common causes of Chronic Renal Failure (CRF) in the United States” ultimately leading to Renal Replacement Therapy (RRT). Statistics on the number of end-stage renal patients have been seen to be on the increasing trend since 1996 with patients on dialysis showing a similar trend. (MEDPAC, 2009, 1) This essay is hereby written to discuss the impact of the concept of demand and supply on resorting to dialysis, as an end-stage renal service and mainstay of RRT. Demand for Dialysis The article written by Infiniti Research Limited (2010, 1) proffer that “end-stage renal disease (ESRD) is an irreversible loss of kidney function, which requires treatment with dialysis or transplantation.” The treatment, through dialysis, includes artificial means for removal of toxins and excess fluids from the bloodstream. The numbers of patients with end-stage renal disorders have been increasing due to factors such as dietary habits of people in general (preference for high protein, high sodium diet), prolonged mistreatment for chronic illnesses such as diabetes and hypertension; inaccessibility to medications and treatment; and lesser people willing to donate their kidneys needed for possible transplant. According to the statistics published by MEDPAC (2009), the number of end-stage renal patients in the US for the 10-year period 1996 to 2006 appears below: TOTAL PATIENTS ON DIALYSIS 1996 308,000 234,000 2001 412,000 297,000 2006 506,000 355,000 As shown, the total number of patients is increasing by a decreasing trend (34% from 1996 to 2001 and 23% from 2001 to 2006). On the other hand, those patients on dialysis are also increasing at the same decreasing trend (27% from 1996 to 2001 and 13% from 2001 to 2006). A variety of factors contribute in the decline in trend. One is the increasing costs for dialysis makes this service inaccessible to all. Although Medicare’s End-Stage Renal Disease Program “entitle people of all ages to health-care coverage on the basis of a single diagnosis: chronic kidney failure,” (USA Today, 2009, 1) long term care is simply not financially viable. As reported in USA Today, “in 2007, Medicare spent $8.6 billion on the treatment and medications of dialysis patients, from babies to the elderly, according to the Medicare Payment Advisory Commissions March report to Congress.” Further, Rita Rubin revealed that “Medicare benefits dont kick in until patients are at the most advanced stage”. (USA Today, 2009, 1) In addition, Rubin (2009, 1) emphasized that “only the wealthy could afford long-term treatment.” People from higher income class eventually resorted to home dialysis which provided them the luxury of more frequent and longer treatments resulting to higher survival rates. Supply for Dialysis Rubin averred that “only 8% of U.S. dialysis patients treat themselves at home. The vast majority of the more than 350,000 Americans on dialysis are treated in centers, where three treatments a week, three or four hours each, is the norm.” (USA Today, 2009, 1) There are profit dialysis centers that abound in the country. Some of these are: Fresenius, DaVita, hospitals, small chains and independent centers. The MEDPACK report below shows the percentage shares of profit dialysis centers in the USA: As shown in the bar chart, 57% of the end-stage renal patients on dialysis are being served by Fresenius and DaVita, with Fresenius being the market leader. Approximately 103,000 patients are being served in over 1,300 outpatient dialysis facilities and acute units in over 800 hospitals. (DaVita Inc., 2004-2009) As the number of people with end-stage renal diseases increase, profit dialysis centers have intensified their marketing efforts to promote and provide dialysis services at more competitive advantages. It has been identified as a growing business given the increasing number of patients requiring availment of this service. Rubin (2009, 1) averred that “the number of U.S. centers has increased 4% every year, according to a June report by the Medicare Payment Advisory Commission. In 1998, there were 3,394; in 2008, 4,957. About 60% are owned by Denver-based DaVita, a Fortune 500 company, and Fresenius Medical Care North America, a Waltham, Mass.-based subsidiary of a German company that operates centers in 28 countries and also sells dialysis machines and other supplies.” Likewise, it has been found to be a lucrative business with revenues increasing for both market leaders. “In the first quarter of this year, DaVitas revenues were $1.45 billion, up more than 8% from the first quarter of 2008. Fresenius revenues from dialysis in North America were $1.57 billion, up 5% over the first quarter of 2008.” (Rubin, 2009, 1) The prospects for profits from this industry is luring other centers and chains to increase their respective market shares through employing strategies such as price discounts and promotions. Analysis Chronic illness causes a disruption in normal functional abilities of an individual. The onset of these illnesses may cause irreversible lifelong changes. In this regard, health care practitioners should never focus on the disease; but rather on the coping mechanisms that would enable the afflicted person to function appropriately despite the illness. The prevalence of dialysis centers aiming to address end-stage renal illness have proven that the demand for their services had been consistently and continuously increasing over time. This phenomenon would require an increase in health care practitioners who should be trained to attend to these patients’ needs. It is not enough that the demand and supply be determined and established. This information should be used to design appropriate health care. There should be goals for caring for people with chronic illnesses. These goals should include the following: (1) coping with lifestyle changes and the subsequent modification of self-care activities; (2) coping with long-term discomfort or pain; (3) establishing or maintaining a sense of personal control; and (4) maintaining a positive self-esteem. (Edelman & Mandle, 2002, 456). By these discourse, the main focus for nurses is to instill and develop coping mechanism for patients with chronic illness, especially those with ESRD. Nurses should emphasize the need to enforce to the patients the things which can be done and not to focus on the illness itself. Conclusion Dialysis in the US has evolved from according ESRD patients with standardized treatments to one necessitating immediate improvement given the challenges in health care and the concept of demand and supply. As patients become more aware of various alternatives to this type of treatment, Congress is faced with demands to upgrade the current system to incorporate changes in pricing and standardizing provision of services by dialysis centers and chains to benefit more patients and decrease the rates of death. In the article on Prevention of Chronic Illness, Breslow (1956) proved that this has been the concern of health care practitioners as early as 5 decades ago. His conclusion is aptly quoted here to confirm that this issue is still relevant and true until the present times: “health departments, state and local, working with the medical profession, voluntary health agencies, and many other community groups are now gaining the experience necessary to carry through the next great achievement in preventive medicine-the prevention of chronic illness. In this endeavor they will need and receive the broadest possible public support.” (1542) More than public support, it is really the individual’s attitude and state of mind towards health and illness which would determine the state of one’s health condition in life. Despite chronic illness and their possible debilitating effects, the most that a health practitioner can provide is good education and support. An individual with chronic illness can still stay healthy if all preventive measures are enforced and if a positive attitude is maintained. References Breslow, L. (1956). Prevention of Chronic Illness. American Journal of Public Health. Retrieved on January 18, 2010 from Daniels, R., Nosek, L. & Nicoll, L. (2007). Contemporary Medical-Surgical Nursing. Delmar Learning. USA. DaVita Inc. (2004-2009). Mission and Values. Retrieved January 18, 2010. Delaune, S.C. & Ladner, P.K. (2006). Fundamentals of Nursing: Standards & Practice. Delmar Learning. Singapore. Edelman, C. & Mandel, C.L. (2002). Health promotion throughout the life span. (5th ed.) St. Louis, MO: Mosby. Infiniti Research Limited. (2010). Dialysis Products Market in United States 2008 – 2012. Retrieved January 18, 2010. Managing Care for Adults with Chronic Conditions. (2002). Agency for Healthcare Research and Quality. Retrieved January 18, 2010. MEDPAC: A Data Book: Healthcare spending and the Medicare program. (June 2009) Retrieved January 18, 2010. < http://www.usatoday.com/news/health/2009-08-23- dialysis_N.htm> MEDPAC, Report to the Congress. Medicare Payment Policy. (March 2009) Retrieved January 18, 2010. < http://www.usatoday.com/news/health/2009-08-23- dialysis_N.htm> Rubin, R. (2009). “Dialysis Treatment in USA: high costs, high death rates.” USA Today. Retrieved January 18, 2010. < http://www.usatoday.com/news/health/2009-08-23-dialysis_N.htm> Rubin, R. (2009). “Many Skip Preventive Care.” USA Today. Retrieved January 18, 2010. < http://www.usatoday.com/news/health/2009-08-23-dialysis_N.htm> Read More