臨牀透析 Vol.22 No.10(2-3)


特集名 移植腎機能喪失後の透析再導入とケア
題名 [各論]透析を再開する患者の経済上の問題
発刊年月 2006年 09月
著者 山﨑 奈美恵 札幌北楡病院療養情報センター・移植コーディネーター
【 要旨 】 腎移植後,さまざまな理由で透析の再開を余儀なくされる患者にとって経済上の問題は決して少ないものではない.学生であれば透析治療のため,学習時間の削減による成績不振,進学率の低下,就職活動への影響などがあげられる.社会人であれば残業等の労働時間削減による賃金の減少,事務職などへの会社内での配置転換,リストラ対象者としてのリスクが高くなるなどの問題かあげられる.また,少子化への影響や旅行などのレジャー利用の減少,失業保険給付対象者の拡大や医療費の増大,障害年金再給付など,日本全体の経済にも影響を及ぼしている.今後は,透析導入時や移植を希望する段階から,これらの問題点や支援策を把握し検討する必要があると思われる.
Theme Dialysis Re-initiation and Related Cares after Functional Loss of Transplanted Kidney
Title Economic considerations for patients requiring reintroduction of hemodialysis after kidney transplantation
Author Namie Yamazaki Treatment Information Center, Sapporo Hokuyu Hospital / Transplant Coordinators
[ Summary ] Economic considerations are important for patients who need be reintroduced to hemodialysis due to impaired renal grafts, or other reasons, after kidney transplantation. In the case of students, hemodialysis is a time consuming treatment which may reduce their time available for study. This may result in a poor academic record, problems in passing exams for good schools, and difficulty in finding employment. For adults, it may affect their working hours and their ability to work overtime. This may result in reduced wages, and in the case of personnel reshuffles, may lead to loss of employment. In addition, hemodialytic therapy may increase the number of people who receive unemployment benefits and disability allowances. This results in higher medical costs. It may also result in a reduction in the number of children they have and reduce time spent on leisure activities such as travel or sports. This may also affect the economic condition of Japan. In conclusion, we consider that it is important we understand these problems and explain them to patients who wish to undergo kidney transplantation.
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