Abstract
End-stage renal disease (ESRD) care is sustaining the lives of over 300,000 individuals today, but with a quality of life and life expectancy that is less than desirable. Nearly 500,000 individuals will be ESRD patients in the year 2005. Will they receive better ESRD care in 2005 than patients receive today? ESRD care modalities are examined in terms of effectiveness (quality of life and life expectancy), accessibility, and affordability from the patient's perspective. Developmental programs with potential to improve ESRD care within the next 5 years are reviewed for potential impact on effectiveness, accessibility, and affordability. The potential effects of global capitation on the quality of ESRD care and the successful development of advanced renal replacement therapies are also examined.
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