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Table 6 Comparison the health policies on the health care providing and reimbursement among the three schemes

From: Mortality and treatment costs of hospitalized chronic kidney disease patients between the three major health insurance schemes in Thailand

Issues SHI UCS CSMBS
Financial barriers to equitable access Acute complications occurred, the patients had access to special care without barrier by referral system.
Administrative efficiency Three health care schemes applied the same clinical practice guidelines
Patient and provider autonomy The patients received the care from only the self-registry hospitals (either private or public hospitals). Treatment of ESRD was hemodialysis or CAPD depended on facility of the self-registry hospitals. The patients received care only the public hospitals in their casement areas, mostly community or general hospitals. The patients were referred to higher facility hospital whenever the complications occurred. CAPD was the first treatment for ESRD patients. The patients freely chosen the public or tertiary care hospital that they preferred. Physicians had autonomy to choose hemodialysis or CAPD for treatment of ESRD.
Non-financial barriers to equitable access Most of the patients worked in the big cities in Bangkok and central region of Thailand which had better population/nephrologist ratio than UCS Most of the patients were in the rural area that had least population/nephrologist ratio Most of the patient chosen to be care in the tertiary care hospitals and medical school hospitals which had best population/nephrologist ratio
Reimbursement of erythropoietin administration    
 - Pre-dialysis No No Yes
 - Dialysis Yes Yes Yes
Reimbursement of dialysis for ESRD patients    
 - CAPD Yes Yes Yes
 - Hemodyalysis Not more than 1,500 bahts (44 USD)/session and not more than 4,500 bahts (132USD)/week. Hemodialysis was allowed only CAPD was contraindication or having complications. Not more than 1,500–1,700 bahts (44–50 USD)/session and not more than 3,000–3,400 bahts (88–100 USD)/week. As the actual expenses
  1. Note: ESRD end stage renal disease, CAPD continuous ambulatory peritoneal dialysis, SHI Social Health Insurance, UCS Universal Coverage Scheme, CSMBS Civil Servant Medical Benefit Scheme