2560

ISBN: 978-616-7859-60-6
1: 2559

: 3,500
:
120 3 2, 3, 4
80 5 2550

10210
0 2141 4000 0 2143 9730
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:
:
188/4-5
10120
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(Sustainable Development Goals: SDGs)

48




2560
2559



2560
1

3
4

2559

1 7
7
8
9
9
11
12
12
12

2 17
17
18
18
19
22

3 25
25
25
26
26
36
36
38

4 41
41
41
42
42
44

 5 55
55
55
55
56
58
58
58
59
59

6 Erythropoietin 61
61
61
63
63

7 65
65
65
67

8 69
69
2560 69

75
1 76
2 84
3 104
4 110
 1

1.
(Renal Replacement Therapy: RRT)


30 2550

1 2551
(Kidney Transplantation: KT)
(Continuous Ambulatory
Peritoneal Dialysis: CAPD)
(Hemodialysis: HD) 1 2551
CAPD
2552
1 2553

1 2551

1 | 7
 10 2555
1 2555

1 2551

21 2555
3

2.

2560

2.1
(CAPD) PD First Policy

2.2 (CAPD)
(KT) (HD)
2.3 (CAPD)
(HD) (KT)

2.4

8 | 2560
 2.5

2.6

2.7

3.
3.1

3.2

3.3

4.

2560

1 | 9
 1 2560

() ()
1.
1.1 26,883 3,844,329,100
(CAPD)
1.2 (HD) 19,146 3,196,987,900
1.3 5,060 82,146,900
EPO (HD SelfPay)
1.4
- (KT) 183 61,993,100
- (KTI) 1,639 343,778,300
52,911 7,529,235,300

2560

/ ()


4.1
4.1

10 | 2560
 4.1.1 (CAPD)

()
4.1.2
1 2551
CAPD
1 2551 CAPD


(
)

4.1.3
1 2551
CAPD
4.1.4

5.
1 2559 30 2560

1 | 11
6.
6.1 (CAPD)

6.2 / (HD)

6.3

6.4
PD CAPD
6.5
CAPD HD
6.6 CKD clinic CAPD
6.7

7.

8.
8.1 /


8.1.1 3
1)

12 | 2560


1
2)






CAPD HD KT


CAPD HD
3)
(CAPD)


HD
8.1.2 3
1)

1 | 13
 2)





3)

8.2
8.2.1 /

8.2.2

(CKD Prevention)

8.2.3

8.2.4
(CAPD)
(HD) (KT)

8.2.5 (.)

14 | 2560
 8.2.6 /

8.2.7 .

8.3
8.3.1 /

8.3.2

8.3.3

8.3.4
(CAPD)
(HD) (KT)

8.3.5
8.3.6
8.3.7
/
8.3.1
Service Plan

8.4
8.4.1
8.4.2
8.4.3
8.4.4

1 | 15
 8.4.5
(Buffer)
8.4.6

9.
8

16 | 2560
 2

2


(Continuous Ambulatory Peritoneal Dialysis: CAPD)

1.

(CAPD) PD first policy
CAPD
HD
2 - 3

CAPD HD

(CAPD)
2560
1.1 (CAPD)

CAPD
1.2 Regional Renal Replacement Therapy Center (RRRTC)
CAPD

2 | 17
 1.3 CAPD

1.4

CAPD
1.5

CAPD
1.6 PD
R2R
1.7

2.
2.1
(CAPD)

2.2
CAPD
2.3

3.
2560 CAPD

: CAPD 2560
: 1 2559 30 2560

18 | 2560
4.
CAPD

4.1
4.1.1 CAPD
2560 CAPD
CAPD
CAPD .
4.1.2 CAPD/ CAPD
1)






2) .
3)
.

4) .
5)
5.1)
III, IV
V (Chronic Kidney Disease clinic CKD clinic)
5.2) CAPD

2 | 19
 5.3)

CAPD
5.4)
()
CAPD case manager
CAPD
CAPD


5.5) CAPD
(HD)
CAPD (Temporary
HD)

5.6)
..
CAPD
CAPD
5.7)


5.8)


5.9)

20 | 2560
 5.10) CAPD

4.2

2
CAPD


DMIS_CAPD
Dialysis (Chronic Kidney
Disease)
4.2.1 (Estimated Glomerular
Filtration Rate: eGFR) 6 .//1.73

4.2.2 eGFR 6 .//1.73


1)

2)
3)
4)
5)
eGFR
eGFR

1) eGFR The Chronic Kidney

Disease Epidemiology Collaboration (CKD-EPI) equation
Schwartz Equation (<18)

2 | 21
 2) Enzymatic
2

5.
5.1
CAPD

(CAPD)
CAPD

5.1.1 CAPD
5.1.2
CBC BUN Creatinine Electrolyte

5.1.3 CAPD
Heparin ( Anticoagulant)
5.1.4
CAPD
(Temporary HD) 1,500
(HD) 90 CAPD
HD HD CAPD
CAPD
CAPD



Temporary HD DMIS-CAPD

22 | 2560
 (Temporary HD)
90

3
1 30
5.1.5 CAPD
(
)

5.2
5.2.1 CAPD Erythropoietin Tenckhoff
catheter
1) CAPD Erythropoietin
Tenckhoff catheter Transfer set, Out port
clamp, Minicap DMIS_CAPD

2)

5.2.2

DMIS CAPD

5.3
30

1) 30
95
2) 60
90

3 | 23
 3) 330
80
() 360

DMIS_CAPD

5.3
7

24 | 2560
 3

3


(Hemodialysis: HD)

1.
(CAPD)


(Hemodialysis: HD)
2560

2.
2.1.
(HD)

2.2.
CAPD HD
2.3.

3 | 25
3.
2560
(HD)
: 1 2559 30 2560

4.
4.1

4.1.1 HD
2560 HD
HD
(Service Plan)

.
4.1.2 HD
/
1)


2)

(.) /
1 .




(1)

26 | 2560
 (1.1)
(.)
(1.2)

3

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(.)
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(2.4)

6
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1
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1 -
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3 | 27

(HD) 4



HD

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28 | 2560
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3

7) HD

8) HD

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.



2) . 2560
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3 | 29

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30 | 2560
 4.1.3 HD
1) HD

3

(HD)

2) HD


3)
1
/ HD

4)
( : HD)
1 HD case manager


5)

6)

7)

(.)

8)
.

3 | 31
 9) HD

/.

10)
Hemo work sheet, ,


11)


HD
HD /

4.2
4.2.1
(Hemodialysis: HD) 2
1) HD
1 2551

( )

1 2555 HD
2) HD
(CAPD) CAPD

32 | 2560
 4.3

3

HD CAPD

4.3

4.3 (HD)

(HD)
4.3.1 CAPD HD 3
CAPD
1)
2)
3)
4)
5)
6)
4.3.2 CAPD HD HD

1) CAPD
2) CAPD
3) CAPD
4.3.3 CAPD HD
CAPD

3 | 33
 1)
2)
3) (BMI>35 ./.)
4) Recurrent diverticulitis
5)
6) CAPD
4.3.4 CAPD HD

1)
2)
3) CAPD



3.1) (Mental retardation)
CAPD
(Absolute contraindication)

3.2)

Peritoneal fibrosis Peritoneal sclerosis Bowel
adhesion Abdominal CT scan
Laparoscopic examination Tenckhoff

3.3) Pleuro peritoneal leak

3.4)

34 | 2560
 Tenckhoff Midline Paramedian
Exit site Healing
( .42/2552 13

3
2552)

4.4
4.4.1. HD CAPD
FM-31812-006

HD
1
2551 CAPD
(FM-31812 00-024)
4.4.2

HD .
4.4.3 . DMIS_HD

(CAPD)
DMIS_HD

4.4.4
DMIS_HD (.)
2
4.4.5 /
. HD

3 | 35
5.

5.1 HD
HD HD 1,500
60

1,700 3 /

5.2
5.2.1 Erythropoietin
5.2.2 (Vascular access)
HD

(Hemodialysis: HD)
.. 2559

6.
6.1

(Hemodialysis: HD)
6.1.1 Dialyzer, Blood line, AVF needle, Bicarbonate dialysate,
Anticoagulant
6.1.2 Glucose,
Analgesic, Antihistamine Transquilizer drug
6.1.3
CBC, BUN, Creatinine,

36 | 2560
Electrolytes, Calcium, Phosphate, Albumin, KT/V, URR, HBsAg, HBsAb, Anti HCV., EKG
Chest X-ray
6.1.4 4 1.

3
() 4 2. Stable
6.1.5

DRG

7
6.1.6

6.1.7

6.1.8

( .)
6.1.9 HD

6.1.10 (
)
HD
.

3 | 37
 ( . 3
1. 2. 7 3.
2 )

6.2 (Vascular access)

6.2.1
/
6.2.2 HD (Vascular Access)
HD
/ HD EPO Vascular Access
6.2.3 HD (Vascular Access)

6.2.4
HD

HD
6.2.5

30

7.

7.1 HD
HD Erythropoietin
HD (.)
HD
Web site . ( HD
)

38 | 2560

7.1.1 (HD)
.

3
7.1.2
7.1.3 .
(REP)
7.1.4 . 1 16
(Statement) 2
7.1.5 . 15
Erythropoietin (EUR) 1
7.1.6
30

7.2 HD (Vascular access)

E- Claim

7.3
30
1) 30 95

2) 60 90

3) 330
80
() 360
2559 30
2560

7.3.1 HD 2

3 | 39
 7.3.2 HD (Vascular access)

30

: HD HD 7.1

7.4
7

40 | 2560
 4

4


(Kidney Transplantation: KT)

1.
(Kidney Transplantation: KT)

2560

2.
2.1

2.2

4 | 41


3.
2560

: 1 2559 30 2560

4.
4.1



.

KT . Data
Center Username Password
KT

4.2
(Kidney Transplantation)
4.2.1 KT

4.2.2

KT case manager
4.2.3 (Kidney Transplantation)

42 | 2560
 4.2.4 (Protocol)

4.2.5 (Protocol)

4.2.6

4.2.7

4.3
20
4.3.1
4.3.2
4.3.3
4.3.4
4.3.5
4.3.6
4.3.7

4.3.8
4.3.9
4.3.10
4.3.11
4.3.12
4.3.13
4.3.14
4.3.15
4.3.16
4.3.17

4 | 43
 4.3.18
4.3.19
4.3.20
:

4.4
4.4.1


(Donor)
4.4.2
DMIS_KT
KT

5.
KT
(Protocol)
Protocol
Protocol 2

5.1
5.1.1
5.1.2

5.2
(Protocol)

2

44 | 2560
 5.2.1 Protocol I-IV
5.2.2 Protocol
1) Antibody Mediated Rejection Protocol AMR-A

4
Protocol AMR-B
2) Acute Cellular Rejection Protocol ACR-A Protocol
ACR-B
3) Delayed Graft Function Protocol DGF-A Protocol DGF-B
Protocol DGF-C

2

(Protocol)
1.
1.1 (Donor)
1.1.1 (Living donor)
1.1.1.1 40,000
(Living donor)
HLA


2 1
1.1.1.2 32,800
(Living donor)

4 | 45

(Protocol)
1.1.2 (Deceased donor)
1.1.2.1 Donor 40,000
(Deceased
donor) (

)
1.2 (Recipient)
1.2.1
1.2.1.1 31,300

HLA


1.2.2
1.2.2.1 31,300

HLA


1.2.2.2 Panel reactive Panel reactive antibody 1,800
antibody 3 /
2.
2.1
Protocol-I 143,000

Low risk

Cyclosporine
+ Mycophenolate
Complication
Cyclosporine Mycopheno-
late

46 | 2560

(Protocol)
Cyclosporine level

4

Protocol-II 148,000

Low risk

Tacrolimus +
Mycophenolate
Complication
Tacrolimus Mycophenolate

Tacrolimus level

Protocol-III 287,000

High risk

Basiliximap +
Cyclosporine + Mycopheno-
late
Complication Basiliximab X 2 dose
Cyclosporine Mycopheno-
late
Cyclosporine level

Protocol-IV 292,000

High risk

Basiliximab +
Cyclosporine + Mycopheno-
late
Complication Basiliximab X 2 dose
Cyclosporine

4 | 47

(Protocol)
Tacrolimus Mycophenolate

Cyclosporine level

2.2
Protocol ACR-A (Acute Ultrasound guided renal biopsy 23,000
Cellular Rejection)
Protocol Methylprednisolone
Acute Cellular
Rejection

Acute hemodialysis (
Aute hemodialysis Protocol
DGF-B)
Protocol ACR-B (Refractory Ultrasound guided renal biopsy 493,000
Acute Cellular Rejection)
Protocol Methylprednisolone
Refractory Acute Anti-thymocyte globulin
Cellular Rejection


Acute hemodialysis (
Acute hemodialysis Proto-
col DGF-B )
Protocol AMR-A (Antibody Ultrasound guided renal biopsy 340,000
Mediated Rejection)
Protocol
Antibody Mediated
Rejection
Methylprednisolone
Intravenous immunoglobulin
Plasmapheresis Plasma
flux
Double lumen catheter

48 | 2560

(Protocol)
Acute hemodialysis (

4
Acute hemodialysis
Protocol DGF-C)
Protocol AMR-B (Refractory Ultrasound guided renal biopsy 426,000
Antibody Mediated Rejection)
Protocol
Refractory Antibody
Mediated Rejection
Methylprednisolone
Intravenous Immunoglobulin
Rifuximab
Plasmapheresis Plas-
maflux
Double lumen catheter
Acute hemodialysis (
Acute hemodialysis
Protocol DGF-C)
Protocol DGF-A (Delayed Ultrasound guided renal biopsy 56,000
Graft Function)
Protocol I-VI
Delay Graft Function

Double lumen catheter
Acute hemodialysis
Protocol DGF-B (Delayed 40,000
Graft Function Acute Cellular
Rejection)
Protocol I-VI Double lumen catheter
Protocol ACR-A B Acute hemodialysis
Delay Gaft Function Ultrasound guide renal
Aute Cellular Rejection biopsy (
Protocol ACR-A
ACR-B)

4 | 49

(Protocol)
Protocol DGF-C (Delayed 35,000
Graft Function with Antibody
Mediated Rejection)
Protocol I-VI Acute hemodialysis
Protocol AMR-A B Ultrasound guide renal
Delay Graft Function biopsy
Antibody Mediated Double lumen catheter (
Rejection Protocol AMR-A AMR-
B)

5.3
5.3.1 3

3
()
40,000 1
40,000
32,800
31,300
PRA 3 1,800

5.3.2
1) ( 4)
2) ( 5)

50 | 2560
 4
Protocol ()
Protocol-I 143,000

4
Protocol-II 148,000
Protocol-III 287,000
Protocol IV 292,000

5
Protocol ()
Protocol ACR-A (Acute cellular rejection) 23,000
Protocol ACR-B (Refractory acute cellular rejection) 493,000
Protocol AMR-A (Antibody mediated rejection) 340,000
Protocol AMR-B (Refractory antibody mediated rejection) 426,000
Protocol DGF-A (Delayed graft function) 56,000
Protocol DGF-B (Delayed graft function with acute cellular rejection) 40,000
Protocol DGF-C (Delayed graft function with antibody mediated rejec- 35,000
tion)
:

1

4 | 51
 1

:
1. Protocol AMR Protocol ACR (
) Protocol 1-4
DMIS-KT

2. Protocol DGF (Delay graft function)

5.3.3
1) Protocol
Protocol

2)

52 | 2560
 2560 (

4
)
3)

4) 21


Protocol
5.3.4

30
5.3.5
DMIS-KT
Protocol

5.3.6
Protocol

30 www.nhso.go.th/acc

7

4 | 53
54 | 2560
 5

1.


(Immunosuppressive drug)

2.
2.1

2.2

3.
: ( 1 2551)
( 1 2551)
: 1 2559 30 2560

5 | 55
4.
(Immunosuppressive drug)

4.1



.

4.1.1 22
1)
2)
3)
4)
5)
6)
7)

8)
9)
10)
11)
12)
13)
14)
15)
16)

56 | 2560
 17)
18)
19)

5
20)
21)
22)
:

4.1.2

/
1)
2)

3)
KT case
manager
4) (Immunosuppressive drug)

5)

6)

4.2

5 | 57

DMIS_KT

5.




()
1-6 30,000
7-12 25,000
13-24 20,000
25 15,000

6.

7.

DMIS_KT 1 /
30

1) 30 95

58 | 2560
 2) 60 90

3) 330 80

() 360
2559 30 2560

8.

9.
7

5 | 59
60 | 2560
 6

6

Erythropoietin

1.

Erythropoietin

2.
2.1 CAPD
HD
1 2551

6

6 Erythropoietin | 61
 6 Erythropoietin
Hct 30% Hct > 30%

Epiao 4,000 4,000 X 8 4,000 X 4
Eporon 4,000 4,000 X 8 4,000 X 4
Renogen 4,000 4,000 X 8 4,000 X 4
Hema-plus 4,000 4,000 X 8 4,000 X 4
Espogen 4,000 4,000 X 8 4,000 X 4
Recombinant 4,000 4,000 X 8 4,000 X 4
Himan EPO*
Eritromax 4,000 4,000 X 8 4,000 Xv 4
Hypercrit 4,000 4,000 X 8 4,000 X 4
Epokine 4,000 4,000 X 8 4,000 X 4
:
Recombinant 31 2560

2.2 CAPD HD Erythropoietin

2.3 Erythropoietin
1

Hematocrit (Hct) 4 HD 8
CAPD
HD HemoSheet

Hct.

2.4 Erythropoietin
CAPD

62 | 2560
 Cold chain
HD

6
3.
3.1
CAPD HD
1 2551
()
3.2
CAPD
3.3

3.4 Erythropoietin Hct

CAPD
HD
3.5 Hematocrit (Hct) Hct
Hct 28
HD 60 CAPD
3.6 1 1
1

4.

4.1 Erythropoietin
4.1.1 CAPD
1) Erythropoietin DMIS_CAPD

15

6 Erythropoietin | 63
 2)
Erythropoietin
10
3) Erythropoietin
Usage Report (EUR) Web site DMIS_CAPD
4.1.2 HD
1) Erythropoietin
(.)
2) .
(REP)
3) . 15

10
4) . Erythropoietin (EUR)
1

4.2
4.2.1 Erythropoietin .

10

4.3
7

Erythropoietin
Erythropoietin CAPD HD

64 | 2560
 7

1.






(
)

2.
2.1 (Continuous Ambulatory Peritoneal
Dialysis: CAPD)

2.1.1
www.nhso.go.th/acc

7 | 65
 2.1.2 Follow up DMIS_CAPD
2.2 (Hemodialysis: HD)
2.2.1
HDepac (.)
HDepac (Download http://cs3.chi.or.th/hdepac)
2.3 (Erythropoietin)
2.3.1 HD
2.2
2.3.2 CAPD

1) Erythropoietin (EUR) DMIS_CAPD

2)
www.nhso.go.th/acc
3) (Hematrocrit)
2.4 (Kidney Transplantation)
2.4.1 Protocol

1)
2)
www.nhso.go.th/acc
2.5
2.5.1
www.nhso.go.th/acc
2.5.2 DMIS_KTI

66 | 2560
3.
3.1 30
ww.nhso.go.th/acc Erythropoietin 30

7
(EUR) 360
2559 30 2560

3.2 HD ( Erythropoietin)

HDepac
3.3
3
3.4 (HD)
.
.
3.5 Website
www.nhso.go.th/acc

7 | 67
68 | 2560
 8

1.




1 2560

2.
2560
2.1

8 | 69
 2.1.1





CAPD
(Measurement HD KT ()
tool) (Prevalence)



(Prevalence )




X

( +
(Numerator) )
( +
(Denominator) )
( +
(Calculation ) x 100
method) ( +
)
DMIS .

3
: DMIS
:






 2.1.2

8



(Measurement
tool)
-
(Numerator)

(Denominator)
-
(Calculation x 100
method)
DMIS
3

: DMIS
:

8 | 71
 2.2
2.2.1 CAPD
CAPD 12
PD first policy
CAPD

CAPD


12

Survival function Kaplan-Meier CAPD
(Measurement ( 90 )
tool)
CAPD
(Numerator)
CAPD
(Denominator)
Kaplan-Meier
(Calculation
method)
DMIS

: DMIS
:






:

72 | 2560
 2.2.2 CAPD
1 (
) (Peritonitis rate, patient-month)

8
PD first policy
CAPD

CAPD

(Peritonitis rate, patient-month)
CAPD 1
(Measurement
tool)
A = CAPD
(Numerator) 1
B =
(Denominator) 1
A/B
(Calculation
method)


:
:
:

8 | 73


1

76 | 2560


1 | 77
78 | 2560


1 | 79
80 | 2560


1 | 81
82 | 2560


1 | 83

2

84 | 2560


2 | 85
86 | 2560


2 | 87
88 | 2560


2 | 89
90 | 2560


2 | 91
92 | 2560


2 | 93
94 | 2560


2 | 95
96 | 2560


2 | 97
98 | 2560


2 | 99
100 | 2560


2 | 101
102 | 2560


2 | 103

3

104 | 2560


3 | 105
106 | 2560


3 | 107
108 | 2560


3 | 109

4

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. 5 08 1858 8955 wipawee.t@nhso.go.th
. 6 09 0197 5284 sarita.s@nhso.go.th
. 7 09 8279 7690 suketa.s@nhso.go.th
. 8 09 0197 5221 wannanapa.sQnhso.go.th
. 9 09 0197 5223 arunruch.k@nhso.go.th

. 10 09 0197 5261 Junchay.p@nhso.go.th

. 11 09 0197 5246 uayporn.p@nhso.go.th

. 12 09 2246 5770 pinyanee.n@nhso.go.th
. 13 . 08 9969 6492 Boonsing.m@nhso.go.th
IT Helpdesk 0 2141 4200 ithelpdesk@nhso.go.th
(
DMIS)
HD HDepac 0 2229 8045
()

110 | 2560


2560 | 111


112 | 2560