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Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives
BACKGROUND: Chronic kidney disease (CKD) is the 12(th) leading cause of death worldwide. Cost-of-illness studies of CKD are scarce in developing countries. This study aims to estimate the cost of illness of all stages of CKD in Lebanon, from early stages until dialysis and kidney transplantation. Th...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063193/ https://www.ncbi.nlm.nih.gov/pubmed/35501814 http://dx.doi.org/10.1186/s12913-022-07936-0 |
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author | Aoun, Mabel Helou, Elie Sleilaty, Ghassan Zeenny, Rony M. Chelala, Dania |
author_facet | Aoun, Mabel Helou, Elie Sleilaty, Ghassan Zeenny, Rony M. Chelala, Dania |
author_sort | Aoun, Mabel |
collection | PubMed |
description | BACKGROUND: Chronic kidney disease (CKD) is the 12(th) leading cause of death worldwide. Cost-of-illness studies of CKD are scarce in developing countries. This study aims to estimate the cost of illness of all stages of CKD in Lebanon, from early stages until dialysis and kidney transplantation. The secondary objective is to identify factors related to the highest financial burden. METHODS: This is a cross-sectional study of CKD patients who presented to two nephrology clinics during November 2020. Their medical and administrative records were reviewed for collection of demographics, CKD characteristics, direct medical costs (medications, diagnostic tests, hospitalizations, inpatient care, outpatient care), direct non-medical costs (transportation) and indirect costs (productivity losses) for one year. Kruskal Wallis test was used to compare the costs between different CKD stages and categories. Logistic regression analysis was used to evaluate risk factors associated with costs. RESULTS: The sample included 102 non-dialysis CKD patients, 40 hemodialysis, 8 peritoneal dialysis and 10 transplant patients. Their mean age was 66.74 ± 15.36 years, 57.5% were males and 42.5% diabetics. The total median cost per year of CKD across all categories was assessed to be 7,217,500 Lebanese Pounds (3,750,000–35,535,250; 1 $USD = 1515 LBP in 2019) from the societal perspective and 5,685,500 LBP (2,281,750- 32,386,500) from the third-party payer perspective. Statistical analysis showed a higher total cost in hemodialysis (p < 0.001), higher cost of medications in transplant (p < 0.001) and higher cost in technique modality in peritoneal dialysis (p < 0.001). In a sub-analysis of hemodialysis patients, dialysis vintage negatively correlated with total societal cost (r = -0.391, p = 0.013); the regression analysis found diabetes as a risk factor for higher cost (OR = 2.3; 95%CI: 0.638,8.538; p = 0.201). In the subcategory of CKD-ND patients, age correlated with total societal cost (r = 0.323, p = 0.001); diabetes and coronary artery disease were significantly associated with higher total cost (OR = 2.4; 95%CI: 1.083,5.396; p = 0.031; OR = 3.7; 95%CI: 1.535,8.938; p = 0.004). CONCLUSIONS: This cost of illness study showed a high burden of hemodialysis and peritoneal dialysis cost compared to transplant and non-dialysis CKD patients. It revealed a significantly higher cost of medications in transplant patients. Health policies should target interventions that prevent end-stage kidney disease and encourage kidney transplantation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07936-0. |
format | Online Article Text |
id | pubmed-9063193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-90631932022-05-04 Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives Aoun, Mabel Helou, Elie Sleilaty, Ghassan Zeenny, Rony M. Chelala, Dania BMC Health Serv Res Research BACKGROUND: Chronic kidney disease (CKD) is the 12(th) leading cause of death worldwide. Cost-of-illness studies of CKD are scarce in developing countries. This study aims to estimate the cost of illness of all stages of CKD in Lebanon, from early stages until dialysis and kidney transplantation. The secondary objective is to identify factors related to the highest financial burden. METHODS: This is a cross-sectional study of CKD patients who presented to two nephrology clinics during November 2020. Their medical and administrative records were reviewed for collection of demographics, CKD characteristics, direct medical costs (medications, diagnostic tests, hospitalizations, inpatient care, outpatient care), direct non-medical costs (transportation) and indirect costs (productivity losses) for one year. Kruskal Wallis test was used to compare the costs between different CKD stages and categories. Logistic regression analysis was used to evaluate risk factors associated with costs. RESULTS: The sample included 102 non-dialysis CKD patients, 40 hemodialysis, 8 peritoneal dialysis and 10 transplant patients. Their mean age was 66.74 ± 15.36 years, 57.5% were males and 42.5% diabetics. The total median cost per year of CKD across all categories was assessed to be 7,217,500 Lebanese Pounds (3,750,000–35,535,250; 1 $USD = 1515 LBP in 2019) from the societal perspective and 5,685,500 LBP (2,281,750- 32,386,500) from the third-party payer perspective. Statistical analysis showed a higher total cost in hemodialysis (p < 0.001), higher cost of medications in transplant (p < 0.001) and higher cost in technique modality in peritoneal dialysis (p < 0.001). In a sub-analysis of hemodialysis patients, dialysis vintage negatively correlated with total societal cost (r = -0.391, p = 0.013); the regression analysis found diabetes as a risk factor for higher cost (OR = 2.3; 95%CI: 0.638,8.538; p = 0.201). In the subcategory of CKD-ND patients, age correlated with total societal cost (r = 0.323, p = 0.001); diabetes and coronary artery disease were significantly associated with higher total cost (OR = 2.4; 95%CI: 1.083,5.396; p = 0.031; OR = 3.7; 95%CI: 1.535,8.938; p = 0.004). CONCLUSIONS: This cost of illness study showed a high burden of hemodialysis and peritoneal dialysis cost compared to transplant and non-dialysis CKD patients. It revealed a significantly higher cost of medications in transplant patients. Health policies should target interventions that prevent end-stage kidney disease and encourage kidney transplantation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07936-0. BioMed Central 2022-05-01 /pmc/articles/PMC9063193/ /pubmed/35501814 http://dx.doi.org/10.1186/s12913-022-07936-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Aoun, Mabel Helou, Elie Sleilaty, Ghassan Zeenny, Rony M. Chelala, Dania Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title | Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title_full | Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title_fullStr | Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title_full_unstemmed | Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title_short | Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives |
title_sort | cost of illness of chronic kidney disease in lebanon: from the societal and third-party payer perspectives |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063193/ https://www.ncbi.nlm.nih.gov/pubmed/35501814 http://dx.doi.org/10.1186/s12913-022-07936-0 |
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