Social Return On Investment For Patient Treated By Continuous Ambulatory Peritoneal Dialysis: A Case Study In Ubon Ratchathani Province, Thailand

PURPOSE: In Thailand, continuous ambulatory peritoneal dialysis (CAPD) has become the first option for renal replacement therapy (RRT) under the universal health coverage scheme (UCS) for more than a decade. However, there is limited evidence to demonstrate the social value of this policy. Hence, this study aims to evaluate the social return on investment (SROI) of end-stage renal disease (ESRD) patients treated by CAPD modality under UCS in Ubon Ratchathani province, Thailand. PATIENTS AND METHODS: This study follows six steps of SROI principle and framework. It is a mixed method of exploratory sequential design divided into 2 parts; the first part is qualitative research using content analytics to ascertain find out what is the cost in societal view and social value outcome. Then in the second part, take it information gathered from the first part was used to create a research tool to quantitatively collect the data from 191 informants. The data has been analyzed to calculate SROI ratio and interpret the amount of social value created per 1 Thai Baht (THB) of investment. RESULTS: The key social value outcomes are; CAPD patients have a good quality of life, not being a burden on society and willing to undergo kidney transplantation in the future. The costs in societal view are direct medical costs reimbursement from the national health security office (NHSO), direct non-medical costs, and indirect costs are CAPD patients’ out-of-pocket expense. The proportion of the costs from NHSO and the patient is 81:19. The SROI ratio is 1.60:1. It means that 1 THB on investment can generate the social value of 1.60 THB. CONCLUSION: The investment for ESRD patient treated by CAPD modality is worth social value benefits.