Regional health authority improves home dialysis and finds substantial savings

The Challenge: Home dialysis use declining in Manitoba

According to the latest figures, Manitoba has amongst the highest incidence (new patients) and prevalence (total patients) of dialysis use in Canada. The Winnipeg Regional Health Authority (WRHA) encourages patients to use the home dialysis service provided by the Manitoba Renal Program. The program provides patients with better outcomes than hospital-based dialysis and helps the province reduce its costs by lowering the requirement for healthcare professionals and hospital space. While the rate of home dialysis use in Manitoba—19 percent—is on par with the national figure, it trails the percentage reported by more successful programs, such as the 27 percent rate in British Columbia. Even more troubling, the current figure may be the high-water mark for the province; home dialysis use is declining in Manitoba.

The Improvement Project: Many choices that meet precise needs of patients

In his evidence review, Dan Skwarchuk, Executive Director, Health Integration and Innovation of the WRHA, with the support of Dr. Paul Komenda, Home Hemodialysis Director of the Manitoba Renal Program, found that successful home dialysis programs satisfy two requirements. It must identify patients early enough so that home dialysis can be promoted, and to ensure home dialysis offerings better meet patients’ needs. Home dialysis isn’t a one-sizefits- all proposition. It must also be diverse and flexible enough to satisfy any number of different patient requirements, circumstances and conditions.

The Result: Key Improvements

Based on this understanding of successful home dialysis programs, Skwarchuk and Komenda took steps as part of an EXTRA improvement project to make the Manitoba Renal Program’s home dialysis substantially more attractive to patients. Their approach featured introducing system improvements to identify patients sooner. For example, enhancing information technology and introducing new lab testing. The approach also offered different types of home regimens that were better tailored to patient needs, such as dialysis during nighttime hours.

The Impacts: Home dialysis jumps by 28 percent, saving $3.2 million

Their approach works. Since its implementation, the Manitoba Renal Program has increased the use of home dialysis by 28 percent, which translates into 71 additional patients dialyzing in their homes. This improvement has saved the provincial health system $3.2 million annually. The savings are the product of one key factor: home dialysis is less expensive than hospital dialysis, as it eliminates the need for expensive hospital space and it requires fewer healthcare workers.

Dan Skwarchuk image

Dan Skwarchuk
Executive Director
Health Integration and Innovation
Winnipeg Regional Health Authority
Winnipeg, Manitoba

Paul Komenda image

Paul Komenda
Medical Director 
Home Hemodialysis
Manitoba Renal Program
Winnipeg, Manitoba


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