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논문분류	춘계학술대회 초록집
제목	Addressing the Decline in Peritoneal Dialysis Prevalence: The 2023 Initiatives of the Peritoneal Dialysis Reimbursement Program in Taiwan
저자	Yen-Hsuan Tai
출판정보	2024; 2024(1):
키워드
초록	Objectives: The global utilization rate of peritoneal dialysis (PD) varies significantly, reflecting differences in clinicians’ discretion, healthcare systems, and government policies. The 5-year cumulative survival rate (2011-2015) for PD patients in Taiwan was 54.9%, ranking second only to South Korea (71.5% in 2013) and the United States (57.8% in 2014). Moreover, the incidence of PD peritonitis in Taiwan has consistently decreased over the years (2016-2020). However, despite the exceptional quality of PD care in Taiwan, the incidence of PD as a dialysis modality declined from 14.2% in 2007 to 9.7% in 2020, and its prevalence decreased from 9.6% in 2011 to 7.8% in 2020, which was lower than those in Hong Kong (67.3%), Norway (23.5%), Singapore (13%), and the United States (12%). Methods: The declining PD utilization rate in Taiwan might be attributed to insufficient information for patients to choose the most suitable renal replacement therapy (RRT) modality. Enforcing a policy to encourage PD therapy among specific patient populations is crucial, given its benefits for proactive patients and reduced hospital visits. To address these trends, Taiwan's National Health Insurance Administration launched a reimbursement program in July 2023, guided by the expertise of the Peritoneal Dialysis Working Committee of the Taiwan Society of Nephrology. Results: This initiative encourages the establishment of new PD units, education for new staff, and an integrative care approach provided by medical centers and their collaborative community clinics. Additionally, this program encourages comprehensive shared decision-making on RRT modality choice and reimburses telemedicine video consultations as well as remote patient management. Table 1 summarizes the items included in this initiative. Conclusions: This initiative is still ongoing and will continue at least until the end of 2024. These efforts are anticipated to further optimize PD care in Taiwan, thereby enhancing the quality of life and clinical outcomes of patients.
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