End-stage renal disease or
end-stage kidney disease is where a person’s kidneys are no longer functioning.
The function of the kidney is to filter wastes and excess fluids from your body,
which are excreted in through a person’s urine. When a person has end-stage
renal disease, the kidney loses the ability to filter toxins and excess fluids
from the blood, which causes electrolytes and waste to build up in your body
(End-stage renal disease 2019). Standard treatment of this disease is through
dialysis three times a week or a kidney transplant.
Before February 1, 2019,
people without health insurance or who are undocumented (Brown 2019), show up
to the emergency department once a week in critical conditions so the federal law
requires they receive emergency treatment. Instead of receiving standard
hemodialysis treatment.
What
changed? Well, there was a study that doctors from Denver Health conducted that
inspired a change in the Colorado policy. Now, undocumented immigrants or
people without health insurance can receive regular hemodialysis treatment.
(Cervantes, et al. 2018)
found that patients receiving standard hemodialysis had higher albumin and
hemoglobin levels in comparison to patients receiving emergency-only
hemodialysis. From this study, they also concluded that overall, those who receive
treatment with emergency-only hemodialysis spend more days in the hospital and have
a higher mortality rate in comparison to those who receive standard
hemodialysis (Cervantes, et al. 2018). In addition, in a 2017 study, they found
that people who only receive emergency-only hemodialysis treatment suffered
from “death anxiety” due to the chronic stress of not being able to get the
proper treatment they needed (Brown 2019).
Dr. Cervantes, one of the
doctors who conducted the first two studies mentioned above also conducted
another study. This third study focuses on other aspects of emergency-only
dialysis such as medical care provides. It was found that medical care
professionals who were unable to treat undocumented kidney patients until they
were in critical condition contributed to physician burnout (Brown 2019).
I think it is crazy to hear
that one study or a few doctors can make a change within the healthcare field
in ways other than providing medical attention to an individual. Doctors can also
change policy when certain policies are unethical.
References:
Cervantes, L., Tuot, D.,
Raghavan, R., Linas, S., Zoucha, J., Sweeney, L., … Powe, N. R.
(2018).
Association of Emergency-Only vs Standard Hemodialysis With Mortality and
Health
Care Use Among Undocumented Immigrants With End-stage Renal
Disease. JAMA Internal Medicine, 178(2),
188. doi: 10.1001/jamainternmed.2017.7039
Brown, J. (2019, February
25). Immigrants here illegally were waiting until near death to get
dialysis.
A new Colorado policy changes that. Retrieved from
medicaid-policy/.
End-stage renal disease.
(2019, August 17). Retrieved from
causes/syc-20354532.
I think this is a very interesting topic especially with it having to do with immigrants that aren't receiving the right medical attention at a time where they actually need it and before it's too late. Also the fact that doctors are able to make changes in the healthcare system in order to help these people out is cool and I think that hospitals should help anyone that comes in regardless of their status, it's their job to provide medical attention regardless, you can't let someone sit and die when you can help them just because they're undocumented or don't have health insurance. So I think it's a good policy and hopefully it does good. It makes me wonder what the mortality rates are of immigrants that don't receive medical attention for things that could have been prevented or treated before it became too late.
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