Exploring Hospital Resources in Providing Continuous Renal Replacement Therapy

Abstract

Background: Acute kidney injury can occur from many reasons. As a result, the body cannot excrete wastes from the body. In Thailand, the number of acute kidney injury patients accessing renal replacement therapy show a decreasing trend with two potential assumptions: true reduction in the number of patients; or inaccessible to the treatment. There are no measures from relevant agencies to address this problem, in addition to different service systems even in the same service providers. Moreover, the reimbursement for continuous renal replacement therapy (CRRT) does not reflect the actual cost of the service. Objective: The objective of this study was to survey the hospital resources for providing CRRT in Thailand. Methods: The study used data from a document review and secondary data from a previous study in Thailand including distribution of hospitals, medical personnel training information and characteristics of patients receiving services. A questionnaire survey on CRRT services in 280 public and private hospitals registered to the National Health Security System in the fiscal year 2020 was undertaken. Results: The survey revealed that hospitals were capable of providing CRRT services to more patients if the reimbursement to hospital increased to an average of 25,563 baht per patient. Given the appropriate reimbursement rates for CRRT services, 88% of the hospitals could provide services to more number of patients with acute kidney injury in critical periods, leading to greater access to CRRT.