Impact of Regional Renal Replacement Therapy Technology and Training Center Project
to the improvement in mortality of patients on peritoneal dialysis

Suwannee Sriprach¹, Nintita Sripaiboonkij Thokanit², Tanapon Meeudon³, Montri Phathong1, Kidkom Salelanont ⁴,Siribha Changsirikulchai⁴

The National Health Security Office Region 4 (Saraburi), Thailand ¹, Ramathibodi Comprehensive Cancer Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University², The National Health Security Office Region 1(Chiang Mai), Thailand³, Renal Division, Department of Medicine, Faculty of Medicine, SrinakharinwirotUniversity, Thailand ⁴

Purpose: The percentage of death of new patients on peritoneal dialysis (PD) under the universal health coverage in the NHSO region 4-Saraburi (NHSO4) in year 2013 was 30.6%, the highest percentage among 13 regions in Thailand. The NHSO set up the Regional Renal Replacement Therapy Technology and Training Center (RRRT-TTC) project in 4 hospitals during 2014-2017. The aim of this project was to provide a training center in each region to support PD units to improve quality of care.

Method: The HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC), Srinakharinwirot University was the RRRT-TTC for PD units covered by the NHSO4. The activities provided by the RRRT-TTC-MSMC were composed of training programs, building service network, and designing program of data management named DPEX for each PD units to monitor their own clinical outcomes. The accessibility to PD service and the percentage of death of new PD patients each year in the NHSO4 before and after having RRRT-TTC-MSMC were compared.

Result: At the end of year 2018, there were 27 PD units registered with the NHSO4. The percentage of patients accessing to RRT in nationwide and in the NHSO4 were 86.1 and 92.8%, respectively. The percentage of death of new PD patients in the NHSO4 was 15.7% which was equal to the mean percentage of death in whole country.

Conclusion: The percentage of death of new PD patients in the NHSO4 declined from 30.6% in year 2013 to 15.7% in year 2018 after having the RRRT-TTC project at the MSMC.