Current status of dialysis and vascular access in Taiwan. Issue 4 (July 2019)

• Record Type: Journal Article
• Authors: Chen, Chun-Fan; Chen, Fu-An; Lee, Tsung-Lun; Liao, Li-Feng; Chen, Cheng-Yen; Tan, Ann Charis; Chan, Chia-Hao; Lin, Chih-Ching
• Is Part Of: Journal of vascular access. Volume 20:Issue 4(2019)
• Page Start: 368
• Page End: 373
• Publication Date: 2019-07
• Subjects: End-stage renal disease -- dialysis vascular access -- arteriovenous fistula -- arteriovenous graft -- hemodialysis -- percutaneous transluminal angioplasty; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729818807336
• Languages: English
• ISSNs: 1129-7298

Abstract

Due to the implementation of the National Health Insurance system in 1995, the number of patients receiving maintenance dialysis has increased rapidly. This contributed to Taiwan to be in an unfortunate position of possessing the highest prevalence of end-stage renal disease globally. Although the age-standardized incidence of end-stage renal disease gradually decreased to −1.1% in 2014, the huge economic burden that comes with dialysis is detrimental to the quality of dialysis treatment. To achieve a balance between economy and quality of care requires multidisciplinary cooperation. Through a variety of chronic kidney disease–related care projects, we have gradually reversed this situation and achieved good results. Further promotion of kidney transplantation and hospice care for terminal patients will improve the situation. With respect to vascular access, the "fistula first" policy is carried out and percutaneous transluminal angioplasty is the mainstay of treatment to resolve vascular access dysfunction. The medical expenses for dialysis and vascular access management are both fully paid for by the National Health Insurance, and patients do not have to worry about the medical expenses. However, the statistics and vascular access monitoring are relatively insufficient in the past. The comprehensive integration of vascular access management into public policy related to kidney disease will complete the missing piece of the puzzle of overall care.