Dialysis patients triple in a decade
The number of patients receiving dialysis treatment at King Edward VII Memorial Hospital has risen by 207 per cent in a little more than decade — and is expected to increase further.
The facility is treating 166 patients, compared with 54 patients in 2002 and 2003. The annual cost of dialysis treatment is about $200,000, which does not include the medication, consultations and cost of other complications an unwell patient might have.
A hospital spokeswoman, who gave the figures, confirmed that the number of patients had risen during the building of the new Acute Care Wing, where the stations are housed.
“In 2009 [when the specifications for the new building were developed] the year-end census was 103, although it was anticipated this number would rise,” said the spokeswoman.
According to the National Kidney Foundation in the US, dialysis is needed when a person has lost about 85 to 90 per cent of their kidney function. It removes waste, salt and extra water, keeps a safe level of certain necessary chemicals in the blood, and helps to control blood pressure.
“We had 19 stations in the old unit, which were much closer than in the new unit,” the spokeswoman said. “We now have 22 stations and can do 16 more treatments per day than in the old unit.”
She said they operated for longer hours, from 4am to 9pm, Monday to Saturday.
According to medical professionals, about half of Bermuda’s dialysis patients suffer from uncontrolled hypertension and a significant proportion of the remainder have diabetes.
The high cost of healthcare arose in the House of Assembly during debate on the Budget focusing on the Ministry of Health, Seniors and Environment, which finished in the early hours of last Tuesday morning.
Health Minister Jeanne Atherden told MPs: “The issues surrounding chronic disease management, in particular diabetes, continue to put enormous strain on the Bermuda Hospitals Board.
“Dialysis services are projected to grow and, on the hospital’s current best estimates, at a rate of 9 per cent by the end of the current fiscal year and by up to a further 10 per cent in the year 2015.
“The Bermuda Hospitals Board is entitled to be paid fairly for all the services which it properly provides, but it has continued to provide care even when payment has not been possible and this impacts its revenues.
“On many occasions during the last year, the Bermuda Hospitals Board has also provided skills and experience, facilities and equipment, to assist with national issues at no charge, and it will continue to fulfil this public commitment.
“But to do so, the Bermuda Hospitals Board has to carefully manage its resources to ensure that its core mandate of providing acute care services is not endangered.
“In short, choices have to be made and if the funds are not there, these additional “free of charge” services will no longer be able to be provided.”
Dietitian and diabetes educator Sara McKittrick, of the Bermuda Diabetes Association, said: “We estimate there are a minimum of 8,000 to 9,000 people living with type two diabetes, which is linked to genetics, lifestyle and obesity. There are also fewer than 150 patients with type one diabetes, which is not linked to obesity or lifestyle.
“As many as 18 to 20 per cent of the population are affected by diabetes if we include those with pre-diabetes,” she said, calling type two diabetes rates in Bermuda “huge” and that dealing with the issue is an “uphill battle.”
Ms McKittrick said: “It’s to do with poor dietary habits, sedentary lifestyles and the genetic predisposition. To reduce the burden of diabetes, intervention is critical for those at risk to delay or prevent the development of the disease.”
Noting the role of hypertension in this health issue, she added: “Any programme you put into place to prevent diabetes will help that.”
In a speech to the Hamilton Rotary Club last September, Dr Michael Weitekamp, the chief of staff of the Bermuda Hospitals Board, said that the Island had one of the highest healthcare costs per capita at $10,562, according to the National Accounts in 2012.
But he said there was little to be proud of in the health outcomes, noting that Bermuda has one of the highest global rates in obesity, diabetes, dialysis and limb amputation, as well as a high incidence of road traffic accident deaths and life-altering injuries.
He said that socioeconomic, environmental and behavioural determinants of health took a back seat to acute interventions, and added that underinvestment in socioeconomic, environmental and behavioural spheres comes back to haunt Bermuda in the form of higher spending on acute care interventions.
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