Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

Abstract

We examined factors associated with healthcare cost, health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) in hemodialysis patients. We conducted a cross-sectional study on 160 patients from January to April 2019 at a hemodialysis center. Socio-demographic, clinical, and laboratory parameters and quality of life (QOL) (using KDQOL-SF-v1.3) were assessed. Monthly healthcare costs were extracted from the hospital information system. The means of healthcare cost, HRQOL, and KDQOL were VND 9.4 ± 1.6 million, VND 45.1 ± 21.9 and VND 51.3 ± 13.0, respectively. In the multivariate analysis, the healthcare cost was higher in patients with a longer hemodialysis vintage (regression coefficient (B): 0.74; 95% confidence interval (95% CI): 0.25; 1.23), comorbidity (B: 0.77; 95% CI: 0.24; 1.31); and lower in those with a higher hematocrit concentration (B: −0.07; 95% CI: −0.13; −0.01). Patients that lived in urban areas (B: 9.08; 95% CI: 2.30; 15.85) had a better HRQOL; those with a comorbidity (B: −14.20; 95% CI: −21.43; −6.97), and with hypoalbuminemia (B: −9.31; 95% CI: −16.58; −2.04) had a poorer HRQOL. Patients with a higher level of education (B: 5.38~6.29) had a better KDQOL; those with a comorbidity had a poorer KDQOL (B: −6.17; 95% CI: −10.49; −1.85). In conclusion, a longer hemodialysis vintage, a comorbidity and a lower hematocrit concentration were associated with higher healthcare costs. Patients who lived in urban areas had a better HRQOL and a higher level of education led to a better KDQOL. Patients with a comorbidity had a lower HRQOL and KDQOL. Malnourished patients had a lower HRQOL.

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

“…Our study showed that total cumulative cost of CKD patients was high. This has also been confirmed by previous studies [ 11 – 18 ]. The most important contributors for total health care cost in CKD patients were cardiovascular hospitalizations (admissions and hospital stay), particularly HF and CKD hospitalizations.…”

“…Of note, CKD represents a major and growing economic problem [ 3 , 11 , 12 ]. Increasing the knowledge about CKD-related costs is mandatory to ascertain how CKD management can be improved, leading to a significant decrease in CKD burden [ 5 , 11 – 18 ]. Unfortunately, data about the impact of CKD on health care costs in Spain are scarce, and most importantly, not focused on a comprehensive approach [ 19 , 20 ].…”

Quality of Life and Associated Risk Factors in Hemodialysis: Perspective from a Center in the Dominican Republic

“…While many studies have shown an association with comorbidities [23,29], some describe that hypertension and diabetes were associated with worse results regarding pain and work status aspect and have been found to a ect the QoL more broadly [13,32]. Our study found no association between hypertension or diabetes and KDQOL parameters.…”

“…Some authors have found better QoL scores in elderly patients, suggesting that 'patients' understanding of the disease, the acceptance of their limitations, and decreased emotional ability are possible explanations for this association [27,28]. Some studies have found increased levels of QoL in younger years than in older years [17,29], with similar results in studies in Nepal and Saudi Arabia [17,30,31]. The lack of consistency in the ndings suggests that more studies are required to test this hypothesis.…”

Study on the Application and Efficacy of Responsibility Nursing in Dialysis Care

“…In terms of adverse emotions, the responsibility nursing group scored lower in SAS and SDS scores than the routine nursing group. Objectively speaking, the medical expenses of hemodialysis are relatively expensive, and the treatment process is long, which brings a burden to the family economy of hemodialysis patients [23]. On the contrary, the whole treatment process will also cause psychological pressure on the patients, which is prone to induce anxiety and depression in patients, resulting in decreased treatment compliance.…”