DIALYSIS PATIENTS

DIALYSIS PATIENTS

2.

Mr Steve Chia Kiah Hong asked the Acting Minister for Health (a) how many dialysis patients are there in Singapore over the past five years; (b) how many of these patients are undergoing dialysis treatment at each of the service providers like SingHealth, National Healthcare Group, National Kidney Foundation, Kidney Dialysis Foundation, private sector hospitals and others for the past five years; (c) what is the total treatment cost per patient for each of the mentioned provider; (d) what is the breakdown of treatment cost provided by each provider for the past five years and the direct Government subsidy to these providers; (e) what is the treatment cost for peritoneal dialysis (water dialysis) and haemodialysis (blood dialysis); and (f) what is the maximum income level to qualify for subsidised treatment at each of these service providers.

Mr Khaw Boon Wan: **** Between 1999 and 2003, the number of patients on kidney dialysis increased from 2,633 to 3,453.

The breakdown by service provider is as shown below:

Column: 3073

Table 1

_Number by Service Provider: 1999 & 2003 _

Dialysis Centre: |

As at Dec 1999: |

As at Nov 2003: ---|---|---

(a) Public Hospitals:

|

|

National Healthcare Group

|

150

|

304

SingHealth Group

|

421

|

542

(b) VWOs (Voluntary Welfare Organisations):

|

|

Kidney Dialysis Foundation

|

158

|

173

National Kidney Foundation

|

1414

|

1512

Others

|

25

|

109

(c) Private sector:

|

|

Private hospitals/dialysis centres

|

465

|

813

Total: |

2633: |

3453: The total cost of treatment varies from patient to patient and will typically include some or all of the following items: cost of dialysis, medications, hospital outpatient consultation, hospital inpatient services for any complication arising from dialysis.

The main cost is for dialysis. There are three types of dialysis: haemodialysis, CAPD (continuous ambulatory peritoneal dialysis) and APD (automated peritoneal dialysis). The cost differs among the service providers as it depends on the type of service and the level of care provided.

Typically, the cost for haemodialysis ranges from about $1,300 to $2,700 per month. The cost for CAPD is around $1,200 per month, while APD will range from about $1,600 to $2,300 per month.

Patients receiving dialysis at VWO dialysis centres are subsidised by the VWOs and/or the Ministry of Health. Generally, each patient on CAPD will receive a Government subsidy of $200 per month. For patients whose medical conditions require them to be on haemodialysis or APD, the Government subsidy is $600 per month. At the moment, the Government subsidy is provided without any means-testing.

Individual VWO has its own pricing, means testing and subsidy policies. For example, while almost all VWOs rely on Government subvention, the National Kidney Foundation has been able to raise its own funding to provide subsidy for most of its patients who require financial assistance. It taps on Government subsidy for only some of its patients.

Dialysis patients managed in public hospitals generally have other illnesses and are more difficult to manage. Their Government subsidy will be about $1,200, $800 and $1,000 per month for haemodialysis, CAPD and APD respectively. There is also no means-testing in public hospitals at the moment.

Column: 3075

Government subvention for the dialysis centres amounted to about $4 million a year. The breakdown by service provider for FY2002/3 is as shown in Table 2:

Table 2

Government Subvention by Service Provider: FY2002/3

Service Provider: |

Subvention ($): ---|---

Public hospitals:

|

National Healthcare Group

|

253,776

SingHealth Group

|

2,091,096

VWOs:

|

Kidney Dialysis Foundation

|

1,247,788

National Kidney Foundation

|

100,721

Others

|

315,860

Column: 3075