Ramathibodi Home Chemotherapy Model (RHCM)

Related SDGs

Ramathibodi Home Chemotherapy Model (RHCM) increases the effectiveness of treatment, reduces costs, improves the quality of life for patients, as well as improves Thailand's cancer care system for people's health sustainability

Cancer is a major global public health problem with an ever-increasingly violent situation, this disease causes the loss of family’s member as well as their lives’ quality. According to the World Health Organization’s report, in 2008, there were 12.7 million new cancer cases and approximately 7.6 million deaths from cancer. It is expected that in the year 2030, new cancer cases will increase up to 21.4 million people.

In Thailand, cancer is one of the top 5 deadly diseases cause the most death in Thailand. In 2020, an average of 342 people died from cancer per day; which means 124,866 people were killed and there were 190,636 new patients of this disease. Cancer treatment by chemotherapy is a popular method for treating cancer patients because it can treat all stages of the disease and can help cure some cases. However, patient need time and money to reach the chemotherapy in the hospital while the number of hospital beds is limited. As a result, patients do not receive treatment according to the treatment plan, which affects the effectiveness of treatment and disease control.

Ramathibodi Hospital; by its multidisciplinary team; including Oncology Specialists, Advanced Practice Nurses (APN), Nurse practitioners in the Short Stay Services, Nurses from the Home Care Nursing Unit, and Pharmacists, jointly developed a new service system under the name “Ramathibodi Home Chemotherapy Model (RHCM)” at the end of 2015 by applying the Basic Drug Knowledge, Drug Stability, Preparation of chemotherapy drugs into specific equipment, as well Managing side effects while patient takes chemotherapy at home, aiming to provide chemotherapy drugs and fluids to Ramathibodi’s cancer patients of who need to receiving continuous chemotherapy in hospital i.e., Colorectal Cancer patients, Neck and Head Cancer patients requiring 5–FU (fluorouracil)-containing chemotherapy without hospitalization. The patient, thus, receives treatment according to the treatment cycle, increasing from 71% to 100%. Reducing the time of the chemotherapy administration process; Seeing a doctor, Drug Administration, and Drug Delivery; from 243 hours to only 6 hours. This also helps patients save medical expenses THB 15,000 per person per treatment. This project, therefore, proposed to the National Health Security Office (NHSO) to be included in the Universal Health Coverage benefits. Furthermore, the project has extended the home chemotherapy administration system towards other hospitals across the country in the hope to improve the system of cancer patient’s care in Thailand to be more efficient as well as creating sustainability for the health of the Thai population.

Currently, we have a lot of cancer patients participation in this project, save on medical treatment costs and reduce bed occupancy rate. Ramathibodi Home Chemotherapy Model (RHCM) received the “Thailand Public Service Award” of the Public Sector Excellence Awards 2017.

Performance of Ramathibodi Home Chemotherapy Model (RHCM)

Year	New case	Visit (time)	RHCM service outcome
Year	New case	Visit (time)	Cost saving (THB)	Bed saving (day)
2016	65	412	1,818,110	1,236
2017	142	1,143	5,043,955	3,429
2018	141	1,690	7,457,835	5,070
2019	140	1,733	7,647,570	5,199
2020	126	1,826	8,057,980	5,478
2021	94	1,516	6,689,970	4,548
2022	115	1,449	6,394,325	4,347
2023 (June)	72	978	4,315,850	2,934
Total	895	10,747	47,425,595	32,241