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Cost estimate of chronic hemodialysis in Kinshasa, the Democratic Republic of the Congo: A prospective study in two centers
Author(s) -
Izeidi Patrick P. M.,
Nlandu Yannick M.,
Lepira François B.,
Makulo JeanRobert R.,
Engole Yannick M.,
Mokoli Vieux M.,
Bukabau Justine B.,
Kwilu Fulbert N.,
Nseka Nazaire M.,
Sumaili Ernest K.
Publication year - 2020
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12802
Subject(s) - medicine , hemodialysis , prospective cohort study , indirect costs , dialysis , logistic regression , end stage renal disease , direct cost , demography , emergency medicine , accounting , sociology , business
Background The number of patients on dialysis has significantly increased worldwide. However, prospective studies estimating the cost of hemodialysis (HD) in sub‐Saharan Africa remain scarce. The present study aimed to evaluate the direct cost of treating end stage renal disease. Determinants of additional direct cost were also assessed. Methods This study is an analytical, prospective study of cost performed at two HD centers in Kinshasa for a period of 3 months among HD patients enrolled consecutively. The cost analyzed includes only expenditures: consultation, HD session, drugs, comorbidities, laboratory tests, and imaging. Transportation, patient hospitalization, and indirect costs are not taken into account. The determinants of the additional direct cost of HD are identified by multivariate logistic regression analysis. P < 0.05 is the level of statistical significance. Findings The average quarterly direct cost of chronic HD in United States Dollars (US$) is $7070 (~US$28,280 annual cost) at a rate of US$287 per patient per HD session. This cost includes the HD session (US$237) and medicine (US$33) costs, which account for 82.5% and 11.3% of the direct costs, respectively. The presence of at least 4 comorbidities (OR adjusted 4.3, 95% CI [1.23–14.95], P = 0.022) and infection (adjusted OR 4.56, 95% CI [1.05–19.85], P = 0.043) emerged as independent determinants of additional direct cost. Conclusion The direct cost of HD is very high in Kinshasa, where more than 80% of Congolese people live on less than US$1.25 a day.