Cost of Hemodialysis Treatment and Associated Factors Among End-Stage Renal Disease Patients at the Tertiary Hospitals of Addis Ababa City and Amhara Region, Ethiopia
Cost of Hemodialysis Treatment and Associated Factors Among End-Stage Renal Disease Patients at the Tertiary Hospitals of Addis Ababa City and Amhara Region, Ethiopia
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DOI：
10.2147/ceor.s256947
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发表时间：
2020-01-01
影响因子：
2.1
通讯作者：
Haile, Tsegaye Gebremedhin
中科院分区：
文献类型：
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作者：
Kassa, Daniel Asrat;Mekonnen, Solomon;Haile, Tsegaye Gebremedhin
目的：血液透析是终末期肾病(ESRD)患者的肾脏替代疗法，这些患者消耗了大量的医疗资源，增加了经济负担。很多因素会影响血液透析治疗的成本，特别是在资源有限的情况下。此外，血液透析的需求可能会随着成本的增加而减少，但在埃塞俄比亚的证据有限。因此，这项研究旨在估算埃塞俄比亚亚的斯亚贝巴和阿姆哈拉地区三级医院ESRD患者的血液透析治疗费用。患者和方法：对172名接受血液透析治疗的ESRD患者进行机构横断面研究。成本测算采用结构化问卷调查和患者病历测算，间接成本测算采用人力资本法。在修正的Park检验后，用广义线性模型(GLM)来确定相关因素。结果：平均每年血液透析治疗费用为121,089.27ETB(4466.59美元)+/-33,244.99(1226.29美元)。直接成本和间接成本分别占总成本的77.0%和23.0%。年龄(ex(B)：1.01，p-Value<；0.001)，最高财富状况(ex(B)：1.09，p-Value：0.008)，8(ex(B)：1.27，p-Value<；0.001)，每月12次就诊(ex(B)：1.34，p-Value<；0.001)，贫血(ex(B)：1.13，p-Value<；结论：终末期肾病患者的年血液透析治疗费用高于全国人均医疗费用，其中三分之二由直接医疗费用承担。高龄、高财富、就诊次数多、贫血和合并症是血液透析费用的相关因素。因此，医疗保健系统必须做出巨大努力来降低成本，减少肾病患者的生命周期。
Purpose: Hemodialysis is a renal replacement therapy for end-stage renal disease (ESRD) patients who consume substantial healthcare resources, which increases the economic burden. Plenty of factors affects the cost of hemodialysis treatment, particularly in resource-limited settings. Moreover, the demand for hemodialysis may decrease as the cost increases, but there is limited evidence in Ethiopia. Thus, this study aimed to estimate the cost of hemodialysis treatment among ESRD patients in the tertiary hospitals of Addis Ababa City and Amhara region, Ethiopia.Patients and Methods: An institutional-based cross-sectional study was conducted among 172 ESRD patients undergoing hemodialysis treatment. A structured questionnaire and patients' medical chart were used to estimate the costs, and the human capital approach was applied to calculate the indirect costs. A generalized linear model (GLM) was fitted after the modified park test to identify the associated factors. In the final GLM, a p-value of < 0.05 and a 95% CI were used to declare the significant variables.Results: The mean annual cost of hemodialysis treatment was 121,089.27ETB ($4466.59) +/- 33,244.99 ($1226.29). The direct and indirect costs covered 77.0% and 23.0% of the total costs, respectively. Age (ex(b): 1.01, p-value < 0.001), highest wealth status (ex(b): 1.09, p-value: 0.008), eight (ex(b): 1.27, p-value < 0.001) and 12 visits/month (ex(b): 1.34, p-value < 0.001), anemia (ex(b): 1.13, p-value < 0.001), and comorbidity (ex(b): 1.09, p-value: 0.039) were the factors associated with the costs of hemodialysis treatment.Conclusion: The annual cost of hemodialysis treatment among ESRD patients was high compared to the national per capita health expenditure, and two-thirds covered by the direct medical costs. Old age, high wealth status, more visits, anemia, and comorbidity were factors associated with the costs of hemodialysis. Therefore, the healthcare system must make a great effort for cost reduction and reduce the patients with kidney disease before they reach end-stages.