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Capacity Planning

We have a mandate to make sure the necessary infrastructure for kidney care is in place across the province. Capacity planning for dialysis involves:

  • understanding the supply of and demand for chronic in-facility hemodialysis services at the regional level
  • anticipating and planning for increased demand for hemodialysis
  • informing the decision-making process for capital projects related to kidney care

Engaging with our regional stakeholders, including Regional Renal Program leadership and Local Health Integration Networks, is critical for capacity planning. We work closely with our regional partners to:

  • validate data
  • establish a common understanding of the current state
  • incorporate local context into planning activities

Capacity Assessments

Capacity assessments project demand over 10 years. They also determine the number and location of dialysis stations required to meet the demand, taking into consideration home dialysis and fallback rates (the proportion of patients who return to having dialysis at the region’s hub hospital after having it at home or a satellite location). Their purpose is to:

  • create a common understanding of the supply and demand for dialysis services within each Local Health Integration Network (LHIN)
  • inform the decision-making process for large dialysis capital projects
  • serve as a basis for discussion between Regional Renal Programs, independent health facilities, the Ministry of Health and Long-Term Care, LHINs and the Ontario Renal Network

Capacity assessments provide an overview of:

  • current and forecasted demand
  • current and projected capacity
  • maps of prevalent dialysis patients per facility by residence postal code
  • current and target home rates
  • dialysis station utilization rates
  • outstanding or planned dialysis capacity proposals

Capacity Planning Model

Our capacity planning model projects the growth in the number of people who will need chronic dialysis across Ontario. These projections inform planning decisions for capital expansions, such as purchasing dialysis stations, acquiring space, or both.

Our capacity planning model guides our planning by providing information such as:

  • projected patient volumes, and the impact on the requirements for chronic dialysis at a facility, Local Health Integration Network (LHIN) and provincial level
  • how the increasing rates of home dialysis affect the demand for dialysis at a facility, LHIN and provincial level
  • geographic areas with a high concentration of people with end-stage kidney disease
  • future need for resources, such as new dialysis stations and units for in-centre hemodialysis services or home hemodialysis training


The provincial dialysis capacity assessment model uses a number of inputs to project the growth in the number of people needing chronic dialysis in Ontario and to estimate the future need for hemodialysis stations at Ontario’s treatment facilities.

These inputs include:

  • regional patient forecasts
  • historical geographic and modality distribution
  • 3-year average home utilization rates
  • current hemodialysis station capacity and use

The model uses time series analysis and geo-spatial analysis to project the prevalent dialysis patient population from fiscal year 2017/2018 to fiscal year 2028/2029 at the Local Health Integration Network (LHIN) sub-region level (smaller planning areas within each LHIN).

It then translates that data into capacity requirements at each Regional Renal Program and associated dialysis facility by using:

  • historical LHIN sub-region to program patient assignments
  • 3-year average home utilization rates
  • historical distribution of patients among facilities within a program

The dialysis capacity requirements at each facility also take into account the effects of fallbacks. These include both people who temporarily switch from home dialysis to in-facility dialysis due to complications, and those who transfer from self-care to full-care facilities. The model uses 15% of capacity reserved for fallbacks, as well as historical fallback patterns, to make sure the assessment reflects different requirements among facilities.