Community Medicine Department, National University, Khartoum, Sudan.
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
J Med Econ. 2024 Jan-Dec;27(1):455-462. doi: 10.1080/13696998.2024.2320506. Epub 2024 Mar 17.
The incidence of end-stage renal disease (ESRD) in Sudan is increasing, affecting the economic status of patients, caregivers and society. This study aimed to measure ESRD's costs, including direct and morbidity indirect expenditures, and to investigate any associated factors and financial consequences.
This cross-sectional study used a standardized questionnaire to collect data from 150 ESRD patients who had been receiving dialysis for at least one year before the time of data collection at 13 specialized renal centres in Khartoum state. Data about sociodemographic, clinical, and economic factors were gathered, and their relationship to the cost of ESRD was examined using both bivariate (Man Whitney test, Kruskal Wallis test and Spearman correlation) and multivariate analytical procedures (multivariate linear regression).
This study reported a median direct per capita ESRD cost of 38 600 SDG ($1 723.2 PPP) annually with an interquartile range of 69 319.3 SDG ($3 094.6 PPP). The median morbidity indirect cost was estimated to be 0.0 ± 3 352 SDG ($ 0.0 ± 149.6 PPP) per annum. In 28.8% of cases, the patients were their family's primary income earner and over 85% were covered by medical insurance. Our study found that none of the study variables were significantly associated with the total cost of ESRD.
Our findings point out considerable direct out-of-pocket expenses and productivity losses for patients and their households. However, these results should be carefully applied for comparison between the different countries due to differences in the cost of medical interventions and insurance coverage. Further longitudinal studies and studies on health finance and insurance policies are recommended.
苏丹终末期肾病（ESRD）的发病率正在上升，影响了患者、护理人员和社会的经济状况。本研究旨在衡量 ESRD 的成本，包括直接和间接医疗支出，并探讨其相关因素和经济后果。
本横断面研究使用标准化问卷，收集了来自 150 名在数据收集时间（收集前至少一年）之前在喀土穆州 13 个专门的肾脏中心接受透析的 ESRD 患者的数据。收集了社会人口统计学、临床和经济因素的数据，并使用双变量（曼-惠特尼检验、克鲁斯卡尔-沃利斯检验和斯皮尔曼相关性）和多变量分析程序（多元线性回归）检查它们与 ESRD 成本的关系。
本研究报告了每年人均 ESRD 直接成本中位数为 38600 第纳尔（1723.2 美元 PPP），四分位距为 69319.3 第纳尔（3094.6 美元 PPP）。估计每年的间接医疗费用中位数为 0.0±3352 第纳尔（0.0±149.6 美元 PPP）。在 28.8%的情况下，患者是家庭的主要收入来源，超过 85%的人有医疗保险。我们的研究发现，研究中的变量均与 ESRD 的总费用无显著关联。
我们的研究结果表明，患者及其家庭存在大量的直接自付费用和生产力损失。然而，由于医疗干预和保险覆盖的成本存在差异，这些结果在不同国家之间进行比较时应谨慎应用。建议进行进一步的纵向研究和健康金融及保险政策研究。
