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November 12, 1982

Continuous Ambulatory Peritoneal Dialysis

JAMA. 1982;248(18):2340-2341. doi:10.1001/jama.1982.03330180086047

Since implementation of the Medicare End-Stage Renal Disease (ESRD) Program in 1973, the number of patients receiving benefits under this program has increased dramatically. In 1980, approximately 55,000 patients received benefits at a cost to the national government of $1.2 billion. This figure does not include expenditures from other sources, such as private insurance and Medicaid. Since Medicare coverage has been extended to virtually any patient requiring dialysis care, more and more patients are being accepted for long-term dialysis who have severe complicating illnesses; and in whom the potential quality of life achievable on dialysis is limited. More than 5% of the total Medicare budget is now being spent on dialysis and transplant patients who represent less than 0.2% of the active Medicare patient population. Since 1973, the percentage of patients receiving home dialysis in the United States has declined steadily from 43% to approximately 11% of the total dialysis