# Investigating the Economic and SocialDeterminants of Home Dialysis Drop-Out

> **NIH NIH K08** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2021 · $170,856

## Abstract

7. PROJECT SUMMARY / ABSTRACT
This K08 proposal aims to provide Dr. Eugene Lin, MD, MS, with the protected time, training, mentorship, and
research experience to allow him to become an independent health services researcher in kidney diseases. As
an academic nephrologist, Dr. Lin focuses his research on health policy issues and efficient care delivery
pertaining to kidney diseases and, in particular, dialysis. Home dialysis offers patients independence and
improved quality of life, and it is less costly to society. However, many patients choose to switch from home
dialysis to in-center dialysis, especially when they do not receive adequate support or when they are not
sufficiently prepared. This dropout from home dialysis is costly and a potential loss in patient and societal well-
being. Recent dialysis payment reform through the end-stage renal disease (ESRD) Prospective Payment
System (PPS) catalyzed an increase in home dialysis use, by making it more profitable relative to in-center
dialysis. However, it is unclear if payment reform simultaneously incentivized the recruitment of patients who
are more likely to drop out or if it led to the emergence of facilities less equipped to support patients on home
dialysis. Additionally, little is known about potential solutions to mitigate home dialysis dropout. To address this
knowledge gap, this study aims to: (1) quantify changes in home dialysis dropout due to the ESRD PPS, (2)
identify changes in the types of facilities offering home dialysis and changes in the composition of patients
receiving home dialysis, and (3) evaluate potential strategies that might decrease home dialysis dropout,
including retraining and periods of respite. Dr. Lin will accomplish these research goals by applying
econometric techniques to a large claims database and by developing a dynamic simulation model of patients
undergoing home dialysis. This proposal is highly likely to make a substantial impact on patient care by
potentially changing how facilities manage patients on home dialysis. Studying the impact of payment reform
will also help policy makers better understand its effects and will help inform the design and refinement of
future policies aimed at improving the provision of home dialysis. To accomplish these aims, Dr. Lin will receive
additional training in econometrics and design science, under the guidance of a multi-disciplinary mentorship
team. The proposed work and career development plan are realistic and feasible within the award period and
will ensure that Dr. Lin develops the skills to compete for R01 funding. In short, this K08 award will provide the
training, research experience, and mentorship needed to help Dr. Lin successfully transition into an
independent health services researcher.

## Key facts

- **NIH application ID:** 10171575
- **Project number:** 5K08DK118213-04
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Eugene Lin
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $170,856
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10171575

## Citation

> US National Institutes of Health, RePORTER application 10171575, Investigating the Economic and SocialDeterminants of Home Dialysis Drop-Out (5K08DK118213-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10171575. Licensed CC0.

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