Direct and Indirect Cost of Treatment for Chronic Kidney Disease among Patients at the Renal Unit of the University of Nigeria Teaching Hospital, Enugu

Abstract

BACKGROUND: Chronic kidney disease (CKD) is a growing global health issue, particularly in low- and middle-income countries. The cost of managing CKD is high, yet there is limited information available regarding this burden in sub-Saharan Africa.

METHODS: This descriptive cross-sectional study involved 100 CKD patients at the Renal Unit of a hospital between July and December 2019. Data was collected using a pre-tested, semi-structured questionnaire. Frequencies, means, percentages, standard deviations, medians, and interquartile ranges were used for data analysis. ANOVA and chi-square tests were also employed to assess correlations.

RESULTS: The mean total monthly cost of treatment was 135,199 ± 81,060 Naira ($417 ± 250), with direct and indirect costs averaging 127,565 ± 76,139.8 Naira ($393 ± 235) and 8,309 ± 16,735 Naira ($26 ± 52), respectively. Direct costs accounted for 94% of the total illness cost, with hemodialysis alone representing 86.1% of the total cost. There were no significant differences in treatment costs across socioeconomic classes. Out-of-pocket spending accounted for 88% of healthcare expenses.
Conclusion: The cost of CKD management is high, with hemodialysis comprising the majority of the cost. Most patients pay out of pocket. It is recommended that a comprehensive health insurance scheme be implemented, especially to cover hemodialysis treatment.