Abstract for: Modelling the Demand for Renal Replacement Therapies: Challenging Assumptions and Influencing Policy

Renal services comprise a growing and costly part of the health system. They provide life saving dialysis and transplant services for patients with kidney failure. Howewver, demand is increasing, costs are rising and there is an increasing shortage of the staff and facilities needed. The response is often to call for more resources The paper describes two case studies which used dynamic modelling to challenge assumptions about the implications of rising demand and to influence policies designed to repsond to it. The key impact of this work was to show that the future demand is as much determined by provider polices as they are by population and disease characteristics. Not all the problems are caused by rising demand and shortage of resources. In these two cases historical investment patterns and clinical practices are key drivers of current problems. Their future is not predetermined by external pressures but modifiable by internal policies.