Division of Nephrology and Hypertension, Department of Medicine, University of Southern California, Los Angeles, CA; Department of Medicine, University of Southern California, Los Angeles, CA.
Department of Medicine, University of Southern California, Los Angeles, CA.
Adv Chronic Kidney Dis. 2020 Sep;27(5):390-396. doi: 10.1053/j.ackd.2020.06.003. Epub 2020 Jun 24.
The coronavirus (coronavirus disease-2019) pandemic has changed care delivery for patients with end-stage kidney disease. We explore the US healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the coronavirus disease-2019 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and after the coronavirus disease-2019 pandemic can bolster our ability to optimize care for patients with end-stage kidney disease. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.
冠状病毒（COVID-19）大流行改变了终末期肾病患者的医疗服务模式。我们探讨了美国的医疗保健系统，包括与透析护理相关的现有政策、为应对 COVID-19 危机而实施的调整措施，以及政策制定者和肾病学家的可能下一步措施。其中包括与资源管理、远程医疗使用、透析通路手术的优先排序、家庭透析模式的扩展、行政职责和质量评估相关的政策。政府已经制定了一些政策，这些政策已经为医疗保健提供者提供了一些灵活性，以帮助他们集中精力应对这场危机。然而，在 COVID-19 大流行期间和之后的未来政策可以增强我们为终末期肾病患者优化护理的能力。本观点的关键主题是政策灵活性的重要性、应急准备的明确策略以及最大限度地提高可及性和患者自主性的强大卫生系统。
