The purpose of this study is to analyze the cost and benefit of renal replacement therapy by hemodialysis. Divided Hemodialysis Unit into 4 categories ; small size, medium size, large size, and the unit in provincial area. Using 4 hospital, namely : Lard-sin, Vachira, Sirirach, and Udonthanee Hospital, as a case study. The cost analysis divides service delivery units into two types, unit directly providing care (Hemodialysis Unit), and support units. (X-ray, LAB, and Pharmacy). This study analyze in direct medical cost, direct non-medical cost, and indirect cost. The direct benefits estimated on terms of savings in treatment costs of hemodialysis. The indirect benefits are culculated on the expected life earnings of patients. The study showed in the long term net benefit of large hemodialysis unit was negative (-5,937,392 baht) mean while positive in other hemodialysis units(3,684,561baht in small size, 7,603,273baht in medium size, and 13,549,661 baht in provincial area. The ratio of capital, material and labour cost for all hemodialysis unit are nearly by the capital cost was 24.84%, material cost was 42.54% and labour cost was 32.62%. The total cost per unit of small hemodialysis unit was 2,328 baht, medium hemodialysis unit was 1,950 baht, large hemodialysis unit was 4,068 baht and the unit in provincial area was 1,507 baht. Overview of this result ; total cost of hemodialysis was 6,677,262 bath per year, cost per case was 267,090 baht per year, and unit cost was 2,552 baht. The direct medical cost was 4,656,495 baht direct non-medical cost was 773,054 baht and indirect cost was 1,247,713 baht. The provider cost was 73.62% and patient cost was 26.38%. The total direct cost was 81.32%, and total indirect cost was 18.68%. The total benefit of hemodialysis was 9,574,875 baht per year, benefit per case was 382,995 baht per year, and unit benefit was 3,660.12 baht. The total direct benefit was 58.90% and total indirect benefit was 41.10%. Net benefit of renal replacement therapy by hemodialysis per year was 2,897,612.11 baht and cost-benefit ratio was 1.43. The study concluded that it was feasible to investment.

M.Econ. จุฬาลงกรณ์มหาวิทยาลัย ปี 2545

Hemodialysis, effectiveness, Costs, kidney, Ecomomic