Keywords
Dialysis
Hemodialysis units
Hospital
Peritoneal dialysis
How to Cite
Abstract
Background: Cost analysis studies of chronic kidney disease (CKD) have primarily focused on direct costs. Peritoneal dialysis (PD) is more cost-effective than hemodialysis (HD); however, the time spent by patients and caregivers on treatment is usually not considered.
Objective: To estimate the indirect costs and out-of-pocket expenses associated with chronic kidney disease on peritoneal dialysis compared to hemodialysis in Bogotá, Colombia.
Methods: A cost analysis study was conducted. Out-of-pocket expenses were estimated by the weighted average of monthly events per reported dialysis-related expenditure. Indirect costs were estimated on a monthly basis, taking into account transportation time, dialysis procedure time, and perceived patient and caregiver disability. Univariate and multivariate analyses were performed to compare costs between peritoneal dialysis and hemodialysis. Estimated values in Colombia were shown per minimum wage (MW) in 2023. A significance level of p < 0.05 was considered.
Results: We included 132 patients, 40 on PD and 92 on HD, with a median age of 61 years (IQR: 43.7-72.25), of which 43.9% were female. Patients on PD reported being more occupationally active than those on HD (p = 0.028). Catastrophic expenditure was reported by 28.2% of the cohort. The median out-of-pocket expense was 0.41 MW, USD 112.3 (IQR 55.2-200.1), per month, with no differences between therapies (p = 0.17). Indirect costs were higher among patients receiving HD, at 1.64 MW and USD 447.2 (IQR 201.3-766.2), compared to those receiving PD, at 0.56 MW and USD 153.3 (IQR 46.8-511.1) (adjusted p = 0.0002).
Conclusion: Catastrophic expenditure was reported by 28.2% of the cohort. Indirect costs were higher in HD compared to PD. A larger sample size is required to identify differences in out-of-pocket expenses and between different modalities of PD.
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