Key Points
Question
How have US clinicians planned for and responded to resource limitation during the coronavirus disease 2019 pandemic?
Findings
This qualitative study included interviews with 61 clinicians across the United States. While institutions planned for an explicit and systematic approach to resource allocation in crisis settings, this approach did not address many challenges encountered by frontline clinicians, leaving them to struggle with what constituted acceptable standards of care and to make difficult allocation decisions.
Meaning
The findings of this study suggest that expanding the scope of institutional planning to address a broader spectrum of resource limitation may help to support clinicians, promote equity, and optimize care during the pandemic.
IMPORTANCE Although maintenance dialysis is a treatment choice with potential benefits and harms, little is known about care practices for patients with advanced chronic kidney disease who forgo this treatment. OBJECTIVE To describe how decisions not to start dialysis unfold in the clinical setting.
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