POS-652 THE DIRECT COST OF DIALYSIS IN SRI LANKA

Abstract

Sri Lanka is a welfare country providing all healthcare facilities free of charge including dialysis. We assessed the direct cost of dialysis (haemodialysis-HD, continuous ambulatory peritoneal dialysis-CAPD and automated peritoneal dialysis-APD) in different settings of the country. For the government sector the consumables required for HD, CAPD and APD is uniform throughout all government institutions. We enlisted the consumables required for all dialysis types and obtained the cost from State Pharmaceutical Cooperation (SPC) and State Pharmaceutical Manufacturing Cooperation (SPMC). Calculation of machinery, water, electricity, building and human resource cost for HD in government institutions is shown in Table 01. For CAPD and APD as these are home based treatment modalities the contribution of human resources, electricity, water and building cost for government institutions is negligible. National Hospital Kandy (NHK) is the only government institution that carries out session by session (per cycle) payment scheme (which is also incurred by government) for HD. The payment for a HD session is LKR 3,750/=, which includes Dializer 1.5, Blood line and transducer, Bicarbonate 1A 5L, Bicarbonate 1B 10L, Fistula Needle 16G, disinfectants and HD machine cost. The charges for HD in the private sector was obtained from the 5 private sector hospitals and the mean value was obtained per session. However this does not include the labour cost part. Peritoneal dialysis is currently not carried out in private sector. For the government sector the consumables required for A digital treatment data management system exists only for APD. The costing for the initiation of HD, CAPD and APD was excluded. The LKR values for the final costs are converted to US$ considering exchange rate as 1US$=203.00 LKR.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Results attached (Tables 2 to 7) In Sri Lanka HD is the most expensive dialysis method for government institutions while APD is the cheapest. Per cycle payment method is the cheapest among HD costs. The requirement for a health center in institutions contribute for the high HD cost.