Abstract: Objective  To investigate the items and costs of peritoneal dialysis (PD) management and the reimbursement of the expenses by medical insurance in PD patients from different regions in China, in order to reduce the financial burden of the patients and to promote the use of PD through the standard items and prices of PD and the rational rules of reimbursement by medical insurance.  Methods  A self-designed questionnaire on PD items and medical insurance was used to investigate the PD patients in 137 hospitals that provide PD in 30 provinces and big cities in China. Descriptive statistical analysis was performed on the collected data, and Kruskal-Wallis rank sum H test was used to examine the differences among groups.  Results  The nationwide median rates of reimbursement by medical insurance were 80.0 (70.0, 85.0)%, 85.0 (80.0, 90.0)% and 90.0 (80.0, 90.0)% for residents, urban employees, and retired employees, respectively. The monthly expense of continuous ambulatory peritoneal dialysis (CAPD) was significantly lower than that of automated peritoneal dialysis (APD) (H=26.717, P＜0.0001). The monthly reimbursable amount increased with the monthly total expense of CAPD or APD (H=58.367, P＜0.001). The prices of PD varied significantly in different provinces and big cities. The prices of surgical removal of granulation tissue at the outlet, waste bag, removal of polyester cuff in PD tube, and treatment of PD catheter-related tunnel infections had not been set up in 63%, 60%, 50% and 47% provinces and big cities respectively. The commonly used disposable materials necessary for PD safety such as dressing, waste bag and disinfectants could not be reimbursed by medical insurance in 77% provinces and big cities.  Conclusions   This study analyzed the current administration situations of PD management. We therefore recommend that ①the organization and administration of the basic medical insurance system must be continuously reinforced, and the encouragement mechanisms underlying PD services must be improved; ② the prices of PD items should be properly adjusted to support the passions of the hospitals providing high quality of PD services, and ③ the reimbursable PD items are required to be increased to support the safety and quality of PD services.

Key words: Peritoneal dialysis, Medical insurance reimbursement, Diagnosis and treatment items