Resource requirements for interventional radiologic management of long-term ambulatory hemodialysis patients

OBJECTIVE. The purpose of this study was to determine how many and what typ e of procedures a vascular and interventional radiology service should prov ide for patients at ambulatory-patient dialysis centers and to determine th e necessary resource requirements. These data may provide a realistic start ing point for those engaged in the planning and provision of contractual se rvices to dialysis centers. MATERIALS AND METHODS. Patient records at three dialysis centers for a rece nt 3-year period were examined, and demographic and clinical data were reco rded. Records were cross-correlated with records from the vascular and inte rventional radiology service that had contractually provided all dialysis-r elated procedures. These data generated a monthly procedure volume and case mix per 100 dialysis patients. Facility usage times for 121 dialysis-relat ed procedures were obtained prospectively and used to calculate the expecte d resources needed to service the dialysis patients. RESULTS. The three centers provided 5795 hemodialysis-months to 386 patient s. Of the 386 patients over the 36-month period, 101 died and 92 transferre d from the centers. Three hundred and sixteen patients required 1580 interv entional procedures. Monthly procedure volume per 100 dialysis patients ave raged 27.1 procedures. Observed procedure times were used to calculate expe cted room-time hours required to service the monthly procedural volume and case mix per 100 dialysis patients. CONCLUSION. On average, 500 ambulatory dialysis patients will require the f ull-time use of an interventional suite and the services of a full-time tec hnologist, nurse, and physician to provide necessary dialysis-related proce dures. If resources cannot accommodate this volume, the quality and timelin ess of care for these patients is jeopardized.