Managing the delivery of dialysis therapy: A multiclass fluid model analysis

Motivated by the exceptionally high mortality statistics of dialysis patien ts and the ongoing debate about the adequacy of the current reimbursement f or dialysis in the United States, ave pursue a detailed analysis of the dia lysis delivery system. The analysis is based on a multiclass fluid model fo r the dialysis facility, which combines a pharmacokinetics model of dialysi s and an empirically validated model of dialysis-specific mortality. Assumi ng that the facility operates under budget and capacity constraints, our an alysis determines the main factors that affect the delivery of dialysis. Nu merical results, which are representative of the dialysis environment in th e US, demonstrate the accuracy of the model and provide concrete insights a bout the operations of the dialysis facility. A major finding is that an im provement in the technology of dialysis is likely to have a more substantia l impact on the overall Life expectancy of the dialysis population as compa red to an increase in the dialysis reimbursement rate.