Krit Pongpirul1,2, Talerngsak Kanjanabuch3,4,5, Pongpratch Puapatanakul3,4,5, Piyatida Chuengsaman6, Phongsak Dandecha7, Pornchai Kingwatanakul8, Suchai Sritippayawan9, Anutra Chittinandana10, Somchai Eiam-Ong5, Kriengsak Vareesangthip9, Kriang Tungsanga5. 1. Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 3. Peritoneal Dialysis Excellent Center, Chulalongkorn University, Bangkok, Thailand. 4. Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 5. Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 6. Banphaeo Dialysis Group (Bangkok), Banphaeo Hospital (Public organization), Bangkok, Thailand. 7. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. 8. Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 9. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 10. Division of Nephrology, Department of Medicine, Bhumibol Adulyadej Hospital, Directorate of Medical Services, Royal Thai Air Force, Bangkok, Thailand.
Abstract
BACKGROUND: Peritoneal dialysis (PD) has been the main method of renal replacement therapy under the "PD First" policy in Thailand since 2008. Initially, the proposed 13 key performance indicators (KPIs) raised feasibility concerns because of inequitable distribution of resources such as laboratory facilities and/or specialized health-care staff for PD care throughout the country. METHODS: Data availability and goals from the health-care providers' perspective were explored using an online questionnaire survey for all PD centers registered with the Nephrology Society of Thailand from May to June 2016. The availability of essential data required for each KPI indicator to achieve the desired target was assessed using a 5-point Likert scale. RESULTS: Of the 197 centers, 119 responded to the survey (response rate of 60.41%). PD indicators with a high percentage of strongly disagree or disagree were "PD adequacy measured in the last 12 months" (26.83%), "Total weekly Kt/V ≥ 1.7" (24.59%), "3-year PD technique survival" (21.31%), "Serum parathyroid levels within 150 to 500 pg/mL" (16.94%), and a "3-year PD patient survival" (19.01%). As many as 34.17%, 39.19%, 27.27%, 28.93%, and 22.00%, respectively, did not anticipate that the targets could be achieved. Based on the findings from this survey, the national committee concluded that these indicators be removed, and only eight PD indicators were launched. CONCLUSION: Given the importance of KPIs for quality assurance and financial reimbursement, inputs from health-care providers especially data availability and achievement of targets should be considered to ensure feasibility before the final list of indicators are launched.
BACKGROUND: Peritoneal dialysis (PD) has been the main method of renal replacement therapy under the "PD First" policy in Thailand since 2008. Initially, the proposed 13 key performance indicators (KPIs) raised feasibility concerns because of inequitable distribution of resources such as laboratory facilities and/or specialized health-care staff for PD care throughout the country. METHODS: Data availability and goals from the health-care providers' perspective were explored using an online questionnaire survey for all PD centers registered with the Nephrology Society of Thailand from May to June 2016. The availability of essential data required for each KPI indicator to achieve the desired target was assessed using a 5-point Likert scale. RESULTS: Of the 197 centers, 119 responded to the survey (response rate of 60.41%). PD indicators with a high percentage of strongly disagree or disagree were "PD adequacy measured in the last 12 months" (26.83%), "Total weekly Kt/V ≥ 1.7" (24.59%), "3-year PD technique survival" (21.31%), "Serum parathyroid levels within 150 to 500 pg/mL" (16.94%), and a "3-year PD patient survival" (19.01%). As many as 34.17%, 39.19%, 27.27%, 28.93%, and 22.00%, respectively, did not anticipate that the targets could be achieved. Based on the findings from this survey, the national committee concluded that these indicators be removed, and only eight PD indicators were launched. CONCLUSION: Given the importance of KPIs for quality assurance and financial reimbursement, inputs from health-care providers especially data availability and achievement of targets should be considered to ensure feasibility before the final list of indicators are launched.