在资源有限的环境中实施CRRT退款计划的经验教训
Prit Kusirisin1, Sadudee Peerapornratana2, Jiratorn Sutawong3
1Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Journal of critical care
|April 17, 2025
概括
持续置换疗法 (CRRT) 对严重急性损伤 (AKI) 至关重要. 将CRRT整合到泰国通用覆盖计划 (UCS) 中,改善了患者的获取和治疗效率,尽管最初担心成本.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 卫生政策 卫生政策
- 医疗保健经济学 医疗保健经济学
背景情况:
- 急性损伤 (AKI) 是一种具有高死亡率和慢性病风险的危急疾病.
- 持续性置换疗法 (CRRT) 是严重的AKI的重要治疗方法,特别是在危急病患者中.
- 高昂的CRRT成本对获得CRRT造成了重大障碍,特别是在资源有限的医疗保健系统中.
研究的目的:
- 审查将CRRT纳入泰国通用覆盖计划 (UCS) 的政策制定过程.
- 评估UCS包含在CRRT可访问性和AKI患者结果上的影响.
- 分析报销策略与临床需求和财务可持续性的调整.
主要方法:
- 对CRRT整合提案和决策过程的政策分析.
- 对偿还和预算分配的基于证据的建议进行审查.
- 在UCS政策实施后监测患者的结果和成本效益.
主要成果:
- 在经过严格的政策制定后,2018年接受了CRRT融入泰国的UCS.
- 到2022年,CRRT退款被纳入UCS,从而提高了AKI患者的治疗机会.
- 持续评估患者的结果 (死亡率,恢复,住院) 和节省成本的措施.
结论:
- 将CRRT成功整合到国家卫生计划中,证明了克服成本障碍的可行性.
- 将补偿政策与临床需要相协调,对于公平有效的AKI治疗至关重要.
- 持续的成本效益分析和政策调整对于可持续的医疗保健服务至关重要.
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