Projectisation of setting up of a dialysis centre at a zonal service hospital

Abstract

Dialysis is essential for patients suffering from “End Stage Renal Disease (ESRD)” and it is observed from preliminary studies that the prevalence of Chronic Kidney Disease (CKD), the precursor to ESRD is 0.8% in India. The major contributing causes to CKD are diabetes and high blood pressure among many others. These diseases are increasing at an alarming rate across the country 1. With the increasing global trend of chronic non-communicable diseases and India being the world capital for diabetes and possibly hypertension. The cost of supporting the treatment of patients undergoing dialysis and suffering from ESRD is very high in the order of Rs 10,000 to Rs 20,000 per month. Presently dialysis centres only exist at command level hospitals. Considering the anticipated delay in delivering the dialysis service to the patient in the available facility, time and distance; criticality factors involved and the hassles in availing the facility in civil hospitals, there is an inescapable need to establish haemodialysis units in service hospitals at places far away from Command hospitals where the dialysis facility is available at present. With the sparse availability of dialysis facilities for armed forces and their dependents, clientele, it was conceptualized that enhancing the availability of dialysis services at zonal service hospital level shall reduce the patient suffering and produce better health outcomes. This paper brought out the need, feasibility, process, factors involved and outcome of the proposed projectisation of dialysis facility at zonal service hospital. It is found that projectisation of establishing the dialysis setup in Build Own Operate (BOO) model in Public Private Partnership (PPP) mode has potential effectiveness and efficiency for providing comprehensive dialysis services to the dependent clientele at zonal service hospitals.