NHSO Board Approves Increase in Proportion of New Peritoneal Dialysis Patients.

Bangkok: The National Health Security Board (NHSO Board) has approved the development of a standard system and quality of dialysis policy from the control board, increasing the proportion of new peritoneal dialysis patients by 50 percent, providing sustainable care for chronic kidney failure patients. According to Thai News Agency, Mr. Karom Polpornklang, Deputy Government Spokesperson, revealed that the NHSO Board has approved in principle the 'Proposal for the Development of a Standard and Quality System for Dialysis Policy Under the National Health Security System (Gold Card 30) from the Health Service Quality and Standards Control Committee'. This includes approval for increasing the proportion of peritoneal dialysis services for new end-stage renal disease patients to at least 50 percent. Additionally, the board aims to control the cost of services for patients with chronic renal disease to no more than 12 percent of the Gold Card budget within five years or no more than 15 percent within ten years. The plan also involves reducing the number of new patients with chronic renal disease who choose dialysis to less than 160,000 within ten years by preventing and delaying chronic renal disease in the long term. The NHSO board also decided to reinstate the 'PD First' policy and immediately implement it. Since 2022, monitoring the data of dialysis patients in the system revealed an increase in dialysis patients while the number of peritoneal dialysis patients decreased. Mortality data indicated a significant increase in the death rate of dialysis patients, approximately 5,500 people in the past two years, considered higher than expected. Meanwhile, the mortality rate of peritoneal dialysis patients remained unchanged, and dialysis patients used more care resources than peritoneal dialysis patients. This trend could cause the cost of renal replacement therapy services in the system to increase from 9 percent of the current gold card budget to 20 percent and 30 percent in the next five and ten years, respectively. Furthermore, the NHSO board has set the renal replacement therapy service budget as a closed-end budget (Global Budget), such as capping the budget at no more than 10 percent of the Gold Card Fund service budget in the fiscal year 2025. All these measures aim to ensure the sustainability of the chronic kidney disease patient care system.