Financial burden of Chronic Kidney Disease Patients on Maintenance Hemodialysis in Chittagong, Bangladesh

Abstract

Background: Chronic kidney disease (CKD) is an important public health problem. Renal replacement therapy (RRT) is needed to patients who goes to end stage renal disease(ESRD). Most of the evidence on its costs relates to patients receiving dialysis or kidney trans-plants, which shows that, in these phases, CKD poses a high burden to payers. The aim of this study was to estimate the financial burden of patients with CKD on maintenance hemodialysis. Methods: It is one -year observational study, carried out to collect data on 105 patients with CKD on dialysis taking from different centers of Chittagong Bangladesh. After collection of sociodemographic informations financial status were collected from patients who gave informed written consent to be included in the study. Data were analyzed by SPSS 20. Results: Regarding gender distribution, male was 73(69.5%) and female was 32(30.5%). Male to female ratio was 2.28:1. Age group distribution revealed 10(9.5%) patients were at <30 years, 18(17.1%) were at 31- 40 years, 23( 21.9%) were at 41-50 years, 26(24.8%) were at 51-60 years, 20(19.0%) were at 61-70 years and 8(7.6%) were >71 years age. Among all most were involved in service 40(38.1%) and business 23(21.9%). Socio economic status of the patients revealed 42(40.0%) patients were from upper middle class, 50(47.6%) were from lower middle class. Among all, 33(31.4%) patients took treatment from abroad. Regarding bearing of cost of the dialysis 24(22.9%) were self financed and 35(33.3%) got help from others(non family member), 11(10.5%) took loan and 13(12.4%) sold their stable land property. Regarding tenure of dialysis 31(29.5% patients are getting dialysis <1 year and 74(70.5%) were getting it for 1-2 years. Previous monthly income before start of dialysis was zero(0) in 33(31.4%) patients and it was >30000 taka/month in 34(32.4%) patients and after start of dialysis present monthly income was zero(o) per month in 67(63.8%) patients and >30000 taka/month in 13(12.4%) patients. Regarding expenditure for each dialysis showed 2(1.9%) had zero(0) taka and 46(43.8%) patients needed 1000-2000 taka/session and 41(39.0%) needed 2000-3000 taka /session. Conclusion: Dialysis in CKD patients is a huge financial burden to the patients himself and the family. Government assistance should be provided to all patients who are unable to bear the cost.

Economic Burden of the Stages of Pediatric CKD on the US Healthcare System

“…This is also the case for uninsured patients or resource-poor; such patients present with later stages of CKD when hospitalized primarily due to barriers to receiving timely or preventative care. [20][21][22] This is exacerbated by the lack of pediatric nephrologists in speci c geographic regions. Kula and Somers demonstrated that a lack of pediatric nephrologists in some states can have a myriad of problems ranging from lack of access to care to reduced surveillance of CKD, decreasing the reported true incidence and prevalence of pediatric CKD.…”