A SURVEY OF HOME VISITS AT PERITONEAL-DIALYSIS CENTERS IN THE UNITED-STATES

Objective:To determine the frequency and characteristics of home visit s in centers that provide training for peritoneal dialysis (PD). Desig n: Mail survey sent to all dialysis centers in the United States provi ding home PD, using the Health Care Federal Administration (HCFA) Rena l Provider list. Results: Surveys were mailed to 1247 centers; 13 were undeliverable, resulting in 1234 surveys successfully delivered; 670 (54%) of those surveyed responded. Of those responding, 525 (78.4%) re ported home visits were part of the care of home PD patients: 11% made a single home visit, 52% made an initial home visit with at least one followup visit, and 16% made visits only as needed. No home visits we re made by 21% of responding centers. A registered nurse (RN) alone ma de the home visit in 61% of the centers, while a multidisciplinary tea m accompanied the RN in 35% of centers; 3% of visits were made by a li censed practical nurse, and 1% by the physician. Half of the visits re quired 0.5 - 1 hour, while 41% required 1 - 2 hours. Travel time was m ost often an hour or less one way. Staff were reimbursed for travel ex penses by 90% of the centers. The 525 centers making home visits were not different than the 145 centers not making home visits in number of patients per center, number of RNs, rural or urban location, or affil iation with a university. Interpretation of the HCFA regulations conce rning home visits was the most important factor influencing centers ma king home visits. Conclusions: Home visits to continuous ambulatory PD and continuous cycling PD patients in the United States are common. N early 80% of centers responding to the survey include home visits in t he care of their home peritoneal dialysis patients.