IJCM_199A: Out of pocket expenditure and catastrophic expenditure on haemodialysis: a cross sectional study on patients with chronic kidney disease in Palakkad, Kerala

Abstract

Background: Advances in kidney transplantation and dialysis have helped millions of people with ESRD. However, cost involved in terms of initial investment, maintenance, training, skilled personnel, subsidies on consumables and drugs add to the long-term cost involved with treatment. Objectives: 1. To study the treatment expenditure, out of pocket expenditure and catastrophic expenditure during Haemodialysis. 2) To study sociodemographic characteristics of ESRD patients on Haemodialysis Methodology: It is a cross sectional study conducted in 2 government and 2 private hospitals among patients with chronic kidney disease who were undergoing haemodialysis for a minimum period of 1 month. Data was collected using preformed questionnaire containing data on socio-demographic variables, illness details, dialysis details, medications and other expenditures. Results: 65.7% of participant gave history of having insurance coverage or any assistance for dialysis. But majority of patients used their savings (69.7%), or gifts (60.2%), sold assets (51.2%), made unsecured loans (23.9%), mortgaged their lands (11.9%). In addition, 97.5% had catastrophic expenditure on dialysis. Out of pocket expenditure for dialysis per month was Rs.8,310 in government institutes and Rs.29,655 in private institute. Among private, it was Rs.11,297 rupees in ECHS patients and Rs.18,642 in other social insurance scheme Conclusion: There is a high out of pocket expenditure among dialysis patients for their session with public private disparity