Center or Home Dialysis?

Abstract

To the Editor: In recent years there has been a good deal of controversy about the cost of dialysis.^{1 2 3 4 5 6} Many have advocated home dialysis as less costly than dialysis at a facility. Others have argued that when all factors are considered, home dialysis is not really less expensive. The emphasis in most cases, however, has simply been on the cost of treatment, and not on the implications of various treatment settings for outcomes (e.g., the patient's functional ability, days hospitalized, and longevity). Furthermore, there have been no attempts to determine whether physicians differentially assign patients with end-stage renal disease to . . .