NHSO project boon for those with kidney disease

Each visit, which took the whole day, costs Bt1,800, of which he paid Bt500 per time. The universal healthcare scheme covered the rest.
But now, thanks to the National Health Security Office’s (NHSO) pilot project in Chiang Mai and the Northern region to help subscribers who were having to wait in long queues for kidney disease treatments at public hospitals, his life is much easier.
Saneur was selected as one of 30 kidney patients for the pilot programme, which means he doesn’t have to travel to hospital and wait for hours anymore. His stomach has been surgically attached to tubes for the continuous ambulatory peritoneal dialysis (CAPD) procedure, which is done at home. Again, the cost is covered by the universal healthcare scheme.
“Doing the procedure myself five times a day [6am, midday, 6pm, 10pm and before bed], takes about one hour each time. I can spend the rest of my day working in the field. I don’t need to go to hospital and wait for hours anymore,” he said, adding that the hospital mails to him the glucose liquid packs, each costing Bt105-Bt140 per pack, needed for the procedure.
“I was trained on how to do the procedure and doctors insisted I always keep it clean or it could lead to infection,” he explained. In the meantime, he is on a waiting list for a kidney transplant.
The CAPD method will be effective for five to six years. If Saneur doesn’t have a kidney transplant by then, he will move on to the HD treatment, which NHSO will also cover. For kidney patients to get full coverage for HD treatment – not the partial coverage by NHSO as presently practised – they had to undergo CAPD first.
The idea of this pilot project was to let 19,000 kidney patients under NHSO care gain more access to kidney treatment, through the pilot project already being practised in the northern region centred on Chiang Mai.
Another patient, Jin Jairian, 58, said he has had kidney disease for four months and underwent the CAPD after being trained at home. He said doctors from time to time visited and checked up on him. “I have not had to go to hospital for three months and they mailed me the glucose liquid packs,” he said.
NHSO adviser, Dr Khemrassa-mee Khunseukmen-grai, said the organisation supported the “CAPD First” policy and currently takes care of 19,000 kidney patients (9,600 CAPD patients and 9,300 HD patients) while 800 others needed immune suppressive drugs. NHSO spent Bt3.2 billion on kidney disease treatment last year, and that was predicted to rise over the next 10 years.
However, many patients still must wait in long queues for HD treatment. NHSO has expanded the CAPD network from public to private facilities in Chiang Mai with the Chiang Mai Kidney Clinic as NHSO’s pilot partner. She said the result showed patients accessed the service faster and were less likely to suffer complications while waiting for HD treatment.
Nurse Sumalee Nakham said the CAPD network covered district-level hospitals and clinics for NHSO subscribers, so patients could receive the tube-inserting surgery at the network’s facilities or from the network hospitals’ mobile clinic. She said the CAPD surgery cost of Bt2,000 was covered by NHSO, so overall, NHSO paid the clinic Bt4,000 per person per month.
Chiang Mai Kidney Clinic director Dr Dusit Lamlertkul said his facility was ready to support the NHSO pilot project and it could accommodate at least 300 CAPD surgery cases.
He expressed confidence t this solution would certainly reduce the number of kidney patients waiting for HD treatment.