The prevalence of dialysis in Thailand is 282 per million population, and utilization of peritoneal dialysis (PD) is only 4.6% of the utilization of hemodialysis (HD). The causes of low PD utilization include
a relatively higher cost of PD care, especially from the patient's perspective;
less incentive for PD care on the part of health care providers and hospitals;
fewer continuing medical and nursing education programs in PD;
unavailability of certified PD nurses;
lack of confidence in the quality of PD care;
fewer offers of PD as a renal replacement therapy option during pre-dialysis counseling;
fear of peritonitis on the part of the patient, and also fear of burdening family members;
a less stringent government policy regarding the “PD first” strategy.
To increase PD utilization. mandatory strategies are
lower PD cost,
make all PD equipment reimbursable,
launch a stringent “PD first” policy,
provide incentives to health care providers and hospitals, and
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