Abstract:
Purpose: Hemodialysis is a renal replacement therapy for end-stage renal disease (ESRD) patients
who consume substantial healthcare resources, which increases the economic burden. Plenty of
factors affects the cost of hemodialysis treatment, particularly in resource-limited settings.
Moreover, the demand for hemodialysis may decrease as the cost increases, but there is limited
evidence in Ethiopia. Thus, this study aimed to estimate the cost of hemodialysis treatment among
ESRD patients in the tertiary hospitals of Addis Ababa City and Amhara region, Ethiopia.
Patients and Methods: An institutional-based cross-sectional study was conducted among
172 ESRD patients undergoing hemodialysis treatment. A structured questionnaire and
patients’ medical chart were used to estimate the costs, and the human capital approach
was applied to calculate the indirect costs. A generalized linear model (GLM) was fitted after
the modified park test to identify the associated factors. In the final GLM, a p-value of <0.05
and a 95% CI were used to declare the significant variables.
Results: The mean annual cost of hemodialysis treatment was 121,089.27ETB ($4466.59) ±
33,244.99 ($1226.29). The direct and indirect costs covered 77.0% and 23.0% of the total
costs, respectively. Age (ex(b): 1.01, p-value <0.001), highest wealth status (ex(b): 1.09,
p-value: 0.008), eight (ex(b): 1.27, p-value <0.001) and 12 visits/month (ex(b): 1.34, p-value
<0.001), anemia (ex(b): 1.13, p-value <0.001), and comorbidity (ex(b): 1.09, p-value: 0.039)
were the factors associated with the costs of hemodialysis treatment.
Conclusion: The annual cost of hemodialysis treatment among ESRD patients was high
compared to the national per capita health expenditure, and two-thirds covered by the direct
medical costs. Old age, high wealth status, more visits, anemia, and comorbidity were factors
associated with the costs of hemodialysis. Therefore, the healthcare system must make
a great effort for cost reduction and reduce the patients with kidney disease before they
reach end-stages
