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. 2024 Apr 4;22(1):25.
doi: 10.1186/s12962-024-00530-7.

The economic burden of hemodialysis and associated factors of among patients in private and public health facilities: a cross-sectional study in Addis Ababa, Ethiopia

Tiruneh Amsalu Baye  1 , Hamelmal Gebeyehu  2 , Mahteme Bekele  3 , Semira Abdelmenan  1 , Tigistu Adamu Ashengo  4 , Berhanu Mengistu  5
Affiliations

The economic burden of hemodialysis and associated factors of among patients in private and public health facilities: a cross-sectional study in Addis Ababa, Ethiopia

Tiruneh Amsalu Baye et al. Cost Eff Resour Alloc. .

Abstract

Introduction: The treatment of kidney disease, including hemodialysis, poses challenges in healthcare and finances. Despite limited data on hemodialysis costs and determinants in Ethiopia, existing literature indicates a paucity of evidence regarding the economic burden of hemodialysis. This study aims to evaluate the direct and indirect costs of hemodialysis among end-stage renal disease (ESRD) patients, alongside associated factors, among selected governmental and private institutions in Addis Ababa, Ethiopia.

Methods: An institutional-based cross-sectional study using a simple random sampling technique was conducted from September 10 to November 1, 2021. One hundred twenty-eight patients participated in the study. Data was collected using an interviewer-administered questionnaire. The analysis used proportion and frequency measures of central tendency and linear regression measures. Both simple and multiple linear regression models were used to assess associated factors. The final model used a P value < 0.05 at 95% confidence interval (CI) was used to determine significance.

Result: The mean cost of hemodialysis in a representative sample of selected hospitals in Addis Ababa was 7,739.17 $ ±2,833.51 $, with direct medical cost contributing 72.9% of the total cost. Furthermore, the institution type (private or public) and duration on hemodialysis were associated with an increased cost of hemodialysis.

Conclusion: Our findings underline the necessity for policymakers, program administrators, and healthcare institution executives to prioritize this group, recognizing the substantial load they bear and extending these services in government facilities to a broader patient population.

Keywords: Direct cost; Ethiopia; Hemodialysis; Indirect cost; Renal disease.

Plain language summary

WHAT IS KNOWN?: Chronic kidney disease is the leading cause of sickness and death, affecting an estimated 10% of the population in 2015. Treatment of Kidney disease, including hemodialysis, presents not solely a medical concern but also a financial aspect. Therefore, we tried to assess the direct and indirect cost of hemodialysis among chronic kidney disease patients and associated factors among selected government and private institutions. WHAT DID WE DO?: The study’s objective was to evaluate the direct and indirect costs of hemodialysis in patients with chronic kidney disease and examine the associated factors within selected government and private institutions. We selected the institutions after expert consultation due to their high patient flow. An institution-based cross-sectional study was conducted, using an interviewer administered semi structured-questionnaire. WHAT DID WE FIND?: We found the mean cost of hemodialysis in a representative sample of selected hospitals in Addis Ababa to be 7,739.17$ ±2,833.51$, with direct medical cost contributing 72.9% of the total cost. Furthermore, the institution type (Private or Public) and number of years on hemodialysis were predictors of increased cost. Moreover, our findings have highlighted various strategies employed by patients facing challenges covering these expenses. Most patients resort to seeking assistance from family and friends, reducing the frequency of hemodialysis sessions, and cutting back on prescribed medications. It is important to note that several coping mechanisms can adversely affect patients’ health, given that they involve skipping crucial life-saving treatments. WHAT DO THE RESULTS MEAN?: We found out that the cost of hemodialysis was relatively high among the study participants. Therefore, policymakers, programmers, health institution leaders should pay closer attention to these patients as they face significant health and financial burdens.

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Conflict of interest statement

The authors declare that they have no competing interest.

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