Household cost of chronic kidney disease care among patients seeking health care at Komfo Anokye Teaching Hospital
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Date
September, 2019
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Abstract
Background: Chronic Kidney Disease is currently pandemic. Across the globe,
CKD has catastrophic effects not only on the sufferers of this medical condition but also on
their households being it financially, socially and emotionally. The burdensome nature of
the disease leave in its wake great deal of financial and psychological distress particularly at
the household level. This study sought to estimate the household cost of chronic Kidney
disease to enable relevant stakeholders manage the burden it places on patients, their
caregivers and the society so as to improve their lives.
Methods: A cross-sectional study was conducted from 13th February 2019 to 21st of
May 2019 among 224 people with Chronic Kidney Disease between the ages of 14 to 91
years who were receiving health care at the Komfo Anokye Teaching Hospital. Participants
were interviewed using a structured questionnaire and secondary data obtained from hospital
records. The variables were analyzed using STATA software. Sensitivity analyses was also
done for cost estimates to determine the robustness of the data collected.
Results: The mean cost per person per month for patients with CKD Stage I-V
excluding ESRD on dialysis are GH C 493.71(USD 94.04), GHC 485.42(USD 92.19), GHC
447.01(USD 85.14), GHC 547.57(USD 104.30), and GH C 763.88 (USD 145.50)
respectively. For patients with ESRD on dialysis however, the mean cost per person per
month was very substantial with an estimated cost of GH C 2882.84(USD 549.11).However,
the overall household cost among CKD patients seeking care at KATH was GH C1121.42
(USD 213.60) with GHC 983; USD 187.32(87.70%) being for direct cost whilst GHC
137.98; USD 26.28(12.3%) accounted for overall indirect cost. Majority of patients
(74.56%) had monthly income of not more than GH C1, 000(USD 190.50) but relative to the
overall household cost of GH C1121.42 (USD 213.60), it implies that most patients incurred
a cost of more than 100% of their monthly income to be able to seek CKD care. Patients
spent averagely not less than 5.20 hours anytime they visit the hospital to receive CKD care
and this contributes to loss of productive working hours.
Conclusions: The household cost of chronic kidney disease care was highest in
patients with Stage V CKD especially for those on dialysis as compared to pre-dialysis
patients. The household cost being it economic or social cost has significant implication on
the health care and quality of life of patients living with CKD and their households. It is
therefore suggested that all appropriate stakeholders be actively involved in the creation and
execution of policies and cost-effective strategies to avoid and manage chronic kidney
disease in our setting
Description
A thesis submitted to the Department of Health Policy, Management and Economics Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the degree of Master of Public Health in Health Services Planning and Management.
Keywords
Kidney Disease, Health Care, Patient, Komfo Anokye Teaching Hospital