Noncommunicable05 free power points .ppt

Noncommunicable05 free power points .ppt

1. Kidney
Diseases
Prevention

2. Overview
•The mortality rate of Nephritis, Nephrotic Syndro
me, and Nephrosis (18.15 per 100,000 population)
marching the 7th leading cause of death in 2001
•In the end of 2000, there were 30,129 ESRD (End
Stage Renal Disease) patients in Taiwan
•the ESRD prevalence (1352 per million populatio
n) and incidence (311 per million population) are
both the second highest in the world

3. Prevalence of ESRD
0
200
400
600
800
1000
1200
1400
1600
1800
J
a
p
a
n
T
a
iw
a
n
U
S
C
a
t
a
lo
n
ia
G
e
r
m
a
n
y
B
r
u
n
e
i
G
r
e
e
c
e
B
a
n
g
la
d
e
s
h
A
u
s
t
r
ia
U
r
u
g
u
a
y
C
a
n
a
d
a
S
w
e
d
e
n
C
z
e
c
h
.

R
e
p
.

N
e
t
h
e
r
la
n
d
s
C
h
ile
N
e
w

Z
e
a
la
n
d
A
u
s
t
r
a
lia
F
in
la
n
d
N
o
r
w
a
y
H
u
n
g
a
r
y
B
u
lg
a
r
ia
P
o
la
n
d
T
h
a
ila
n
d
R
u
s
s
ia
p
e
r

m
illio
n

p
o
p
u
la
t
io
n
199819992000

4. Incidence of ESRD
0
50
100
150
200
250
300
350
400
U
S
T
a
iw
a
n
J
a
p
a
n
B
r
u
n
e
i
G
e
r
m
a
n
y
G
r
e
e
c
e
C
z
e
c
h

R
e
p
.
C
a
n
a
d
a
C
a
t
a
lo
n
ia
A
u
s
t
r
ia
H
u
n
g
a
r
y
U
r
u
g
u
a
y
S
w
e
d
e
n
C
h
ile
N
.

Z
e
a
la
n
d
F
in
la
n
d
N
e
t
h
e
r
la
n
d
s
A
u
s
t
r
a
lia
N
o
r
w
a
y
B
u
lg
a
r
ia
P
o
la
n
d
P
h
ilip
p
in
e
s
R
u
s
s
ia
B
a
n
g
la
d
e
s
h
p
e
r

m
illio
n

p
o
p
u
la
t
io
n
199819992000

5. Overview
•Why the ESRD prevalence and incidence are so hi
gh in Taiwan?
–the execution of the National Health Insurance Act
–The novel medical technique increases the survival
–The misuse of the nephrotoxic drugs: NSAID, herbs
–The late referral to the nephrologist
•The average health expenditure of ESRD is about
NT$18 billion

6. Patient Benefit Claims by Category of
Major Illness/injury in 2001
223.25
201.37
65.18
52.31
19.58
17.47
12.69
11.17
66.65
0
50
100
150
200
250
1
0
0

M
il
l
io
n

N
T
$
End-stage Renal Disease
Cancer
Chronic Psychotic Disorder
Respirator-dependent Patients
Acute Cerebrovascular Disease
Malformation and Chromosomal
Abnormalities
Generalized Autoimmune Syndrome
Requiring Lifelong Treatment
Major Trauma
Otherwise

7. Overview
•Factors that affect spending for ESRD
patient care
–Patient’s clinical requirements
–Pre-ESRD education
–Referral timing
–Choice of modality
–Center or home therapy
–Reimbursement

8. Strategy
•Strengthen the education program of kidney
disease prevention (esp. pre-ESRD education)
•Construct the health education system for kidney
disease prevention
•Follow up the patient’s therapeutic outcome by
integrating the health care providers to prevent the
aggravation of renal function and lower the
incidence of ESRD

9. Strategy
•Strengthen the prevention of diabetes and
hypertension to avoid renal disease
complication
•Pursuing the basic research for kidney
disease prevention as the reference of
policy making