Direct cost of hemodialysis in a public hospital in the Dominican Republic

Abstract

Introduction: Hemodialysis represents a high expense for patients with end-stage renal disease, the family budget, and the per capita health expenditure of the Dominican Republic government. Objective: To estimate the direct costs of hemodialysis among patients with end-stage renal disease (ESRD) at Salvador B. Gautier Hospital. Methodology: A descriptive cross-sectional study was conducted among 59 ESRD patients undergoing hemodialysis therapy in a tertiary public hospital in the Dominican Republic from July 26th to August 23rd, 2021. Data were collected through interviews with the participants and a review of clinical records. A total of 718 hemodialysis sessions were studied and direct costs were estimated using the bottom-up method. Results: The mean cost per hemodialysis session was DOP 4,880.51 (USD 85.91) and the mean annual cost was DOP 761,359.56 (USD 13,401.86). Direct medical costs represented 50.06 % and direct non-medical costs 49.94 %. Medical supplies and transportation represented 40.86 % and 24.79 % of total costs, respectively. Conclusions: Hemodialysis imposes a considerable economic burden for the Dominican Republic. The income of the families is not sufficient to cover hemodialysis treatment. To reduce the economic impact of hemodialysis, strategies should be implemented to prevent the progression of chronic kidney disease to the end stage.