Kidney disease, resulting in a high fatality rate, is one of the most important health issues in Thailand. Furthermore, financial barriers due to high cost of treatment and after-care as well as a limitation of suitable service facilities have affected patient care need. The National Health Security Office (NHSO), therefore, has taken initiatives to address this issue not only through its healthcare packages, but also by supporting related healthcare system developments. One of them is the cooperation with the Faculty of Medicine, Srinakharinwirot University to set up Regional Renal Replacement Therapy Technology and Training Center (RRRT-TTC) to provide model of care to slow progression of worsening kidney function in patients with chronic kidney disease (CKD). The continuous ambulatory peritoneal dialysis (CAPD), kidney transplantation (KT) and vascular access clinics have been set up to help patients with end stage renal disease (ESRD) to access renal replacement therapy (RRT) in accordance with PD First Policy. RRRT-TTC has also supported other hospitals to build up networks including academic activities to improve clinical outcomes. The success of its operation has been achieved through interdisciplinary collaboration of such personnel as specialists, nurses, pharmacists, social workers, etc. from a super-tertiary hospital, primary care facilities and community in NHSO Region 4 Saraburi, and members of the Thai Kidney Club.

The policy initiated by NHSO will help patients with CKD and/or ESRD access the health services they desperately need. With the PD First Policy, a lot of CKD and/or ESRD patients, together with their families, can be saved from going bankrupt due to the especially high cost of treatments and, as a consequence, their quality of life would be greatly improved.

 Upon the site visit, participants will learn how NHSO’ benefit packages for such high-cost treatments are deployed to be implemented and achieved and how system management based on holistic and interdisciplinary care for patients with kidney disease is highlighted.