Economics and International Epidemiology of Dialysis
1)Which of the following countries has the highest incident rate for treated ESRD?
a)Canada
b)UK
c)Australia
d)Japan
e)India
2)Countries A and B have the same incidence of treated ESRD but Country A has a 50% higher prevalence. Possible explanations are (more than 1 may be correct)
a)Country B has a lower transplant rate
b)Country A has a higher mortality rate on dialysis
c)Country B starts patients on dialysis earlier
d)In Country A, there is greater use of peritoneal dialysis
e)In country B insurance systems do not pay for dialysis and patients self fund until their money runs out
3)Which of the following countries has the highest percentage of prevalent dialysis patients on PD?
a)Canada
b)US
c)Mexico
d)Germany
e)India
4)Which of the following countries has the highest percentage of prevalent dialysis patients on Home HD?
a)China
b)Canada
c)US
d)Australia
e)Hong Kong
5)Which of the following countries has the highest kidney transplant rate?
a)Canada
b)China
c)Japan
d)US
e)India
6)Name the 2 largest dialysis providers (also known as LDOs or Chains) in the U.S.
7)Which of the following statements about U.S. dialysis is false
a)The majority of dialysis providers are “Private for profit”
b)Providers receive approximately the same funding for HD and PD
c)Physician fees are substantially higher for HD than for PD
d)Mortality rates for dialysis patients are higher than in other western countries
e)Medicare funds dialysis for every US citizen who needs it
8)Why does PD cost less than HD in Canada (more than one reason may be correct)?
a)Staff costs are lower in PD
b)Supply costs are lower in PD
c)Medication costs are lower in PD
d)Infrastructure costs are lower in PD
9)Satellite HD often costs more per patient than in centre HD in Canada because
a)Nurses get paid more in smaller hospitals
b)Economies of scale are less
c)Patients in satellites tend to be sicker
d)Patient transport costs are higher
e)Nursing ratios are less flexible
10)The percentage of prevalent dialysis patients on Home HD in Ontario is in the range of
a)Less than 6%
b)6 to 12%
c)12-18%
d)18-24%
e)> 24%
11)The percentage of prevalent dialysis patients on PD in Ontario is in the range of
a)Less than 6%
b)6 to 12%
c)12-18%
d)18-24%
e)> 24%
12)Which of the following statements concerning transplant in Canada is true (may be > 1)
a)A minority of transplants come from living donors
b)There is still no organ sharing in Ontario except for children and highly sensitized patients
c)Less than 20% of dialysis patients ever get transplanted
d)Transplant rates are falling in Ontario
e)Pre-emptive transplants are associated with higher patient survival rates than transplants on dialysis
13)Typical cost of an in centre HD machine in Canada is
a)$25,000 to 35,000
b)$35,000 to 45,000
c)$45,000 to 55,000
d)$55,000 to 65,000
e)Over $65,000
14)The physician fee for dialysis in Ontario is
a)The same for HD and PD
b)Higher for HD than PD
c)Higher for PD than HD
d)Higher for in centre than home dialysis
e)Capped if the physician has more than 80% of patients on in centre HD
15)In economically poor countries PD often costs more than HD because of which of the following reasons (> 1 answer may be correct)
a)Labour costs are low
b)Material costs are relatively higher
c)Reuse of dialyzers is practiced
d)Imported materials are subject to tariffs
e)Twice weekly HD is common
16)Which of the following statements are true and which are false?
a)Countries with predominantly private for profit dialysis providers are likely to have higher rates of home dialysis.
b)Countries with predominantly private for profit dialysis providers are likely to have higher incidence rates for chronic dialysis.
c)In Canada private for profit dialysis providers are very uncommon.
d)In the US the majority of dialysis providers are private for profit.
e)In Canada the majority of nephrologists caring for dialysis patients are paid fee for service rather than by salary.