The origin of the affair between kidney disease care and policy can be traced back
to the 1960s. Acute dialysis had just become available during and after the Korean
conflict, utilized for those with acute kidney injury. Those afflicted with kidney
failure due to combat-related injuries were flown to mobile ambulatory surgical units
and received life-sustaining dialysis. This treatment reduced the mortality rate associated
with this syndrome from >90% during World War II to ∼50%. In 1963, the Department
of Veterans Affairs Hospitals announced its intentions to open 30 dialysis centers
across the United States to provide chronic sustained dialysis for terminal kidney
failure. Following suit, in 1965, the Public Health Service started the Kidney Disease
Control Program (KDCP) and awarded 12 grants to start 12 dialysis centers across the
country. It wasn't until 1971 that this issue become front-and-center, as outlined
by Rettig in a series of articles.
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References
- The policy debate on patient care financing for victims of end-stage renal disease.Law Contemp Probl. 1976; 40: 196-230
- Special treatment —the Story of Medicare's ESRD entitlement.N Engl J Med. 2011; 364: 596-598
- Origins of the Medicare kidney disease entitlement: The Social Security Amendments of 1972.in: Hanna K.E. Institute of Medicine (US) Committee to Study Decision Making. Biomedical Politics. National Academies Press, Washington, DC1991
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Footnotes
Financial Disclosure: The author declares that he has no relevant financial interests.
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