Expenditure for Hemodialysis: A Study among Patient Attending at Hospitals of Pokhara Metropolitan City, Nepal

Abstract

Incidence and prevalence of chronic kidney disease (CKD) is increasing worldwide. It is contributing significantly to deaths and disability. Every year, numbers of cases of renal failure requiring hemodialysis are also increasing. Government of Nepal has made a provision to support the patients undergoing hemodialysis; nevertheless, the patient has to bear the huge financial and psychological burden for dialysis. This study was carried out to study the expenditure made by the patients for dialysis in the Pokhara Metropolitan City Nepal. This was an institution based cross sectional descriptive study. A total of 157 patients who had dialysis or undergoing dialysis at different hospitals of Pokhara Metropolitan City were interviewed using structured interview guideline. Expenditure records of patients were also reviewed. The study was carried out during August to October, 2018. Results are presented in table and diagrams aided by statistical tests like mean, median, standard deviations and ranges. Majority of the patients were male (61.8%). Mean age of the patients under hemodialysis was 49.75±14.91 years. Majorities were Janajati (53.5) and most of them were unemployed (78.3%). Total expenditure made for hemodialysis was NRs. 32,810 (US$ 289.87). The median monthly out of pocket expenditure for haemodialysis per patients was Nepalese Rupees (NRs) 32,810 (US$ 289.87) in which median monthly indirect cost of hemodialysis was NRs 9,200 (US$ 81.28) and median direct cost of hemodialysis per month was NRs 23610 (US$ 208.59). A great majority (78%) of the respondents faced catastrophic health expenditure for dialysis. Patients with renal failure requiring dialysis faced catastrophic health expenditure. The government should focus on programs supporting for dialysis and pay attention on the preventive measures for occurrence of kidney diseases.
 Key words : Hemodialysis, Expenditure, Patient