Health insurance in hemodialysis vascular access

What is it about?

Most patients initiating in-center hemodialysis without health insurance do not qualify for Medicare until the fourth month of dialysis. This study finds that patients without health insurance are less likely than insured patients to switch from using a catheter to an arteriovenous fistula or graft early in dialysis. Uninsured patients did not appear to “catch-up” in switching to an arteriovenous fistula or graft even after obtaining Medicare coverage in the fourth month. Patients without health insurance at the start of dialysis also have a higher rate of hospitalizations involving a vascular access infection than patients with Medicare. Coverage for vascular access care during the first three months of dialysis could increase arteriovenous fistula or graft use in patients without insurance.

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