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Abstract: TH-PO272

Socio-Demographic Characteristics, Out of Pocket Expenditure and Quality of Life of Hemodialysis Patients in India

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bassi, Abhinav, George Institute for Global Health, New Delhi, Delhi, India
  • John, Oommen, George Institute for Global Health, New Delhi, Delhi, India
  • Shah, Kamal D., NephroPlus Dialysis Centres, Hyderabad, Telangana, India
  • Kotwal, Sradha S., The George Institute for Global Health, Sydney, New South Wales, Australia
  • Joshi, Rohina, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Singh, Sanjay K., George Institute for Global Health, New Delhi, Delhi, India
  • Kolli, Sumathi, NephroPlus Dialysis Centres, Hyderabad, Telangana, India
  • Thota, Prasanna Kumari, NephroPlus Dialysis Centres, Hyderabad, Telangana, India
  • Essue, Beverley M., University of Sydney, Sydney, New South Wales, Australia
  • Jan, Stephen, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Gallagher, Martin P., The George Institute for Global Health, Sydney, New South Wales, Australia
  • Knight, John, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Jha, Vivekanand, George Institute for Global Health, New Delhi, Delhi, India
Background

The Dialysis Outcomes in India (DOI) Study is following a cohort of incident dialysis patients to evaluate the impact of socio-demographic and economic factors on clinical outcomes among end stage kidney disease (ESKD) patients initiated on hemodialysis in India. Here we present the baseline socio-demographic and clinical characteristics and Quality of Life (QoL) in the enrolled subjects.

Methods

A total of 1000 subjects were recruited between Nov 2016 & Mar 2018 in 18 facilities across 10 states in India. Routine medical records were utilized for collection of demographic and clinical information. Structured interviews were conducted to collect socio-economic parameters, including out-of-pocket expenses (OoP), with QoL measured using Euroqol-5D-3L®.

Results

Mean age (±standard deviation) of enrolled subjects was 54±16 years, and there were 341 females. Nearly two-thirds of the participants had school education or less (female 73% and males 62%). Over 80% of the female subjects worked within the home and 44% of the males were either retired or not working. A history of hypertension was reported in 64% of subjects (duration 7±6 years) and diabetes in 50% (duration 8±7 years). Mean monthly family income was reported as US$ 602±408. Only one-third of the subjects had health insurance. The mean monthly OoP expenditure was US$ 491±299 for uninsured subjects and US$ 191±103 for insured subjects. Nearly 9% of the subjects had to change their occupation due to kidney disease and treatment schedules. Mean distance travelled to the dialysis unit was 25±15 kms (female 15±9 and males 21±14 km, respectively). Over 16% of the patients reported severe anxiety/depression and 14% reported severe problems related to activities of daily living. Mean QoL Score on the VAS Scale (0-100), was reported at 58 ± 18 (male) and 64 ± 14 (female).

Conclusion

Our study found high dialysis-related OoP expenditure, particularly in those who were uninsured. Low levels of health insurance coverage represents a major challenge for policy makers in mitigating the economic burden of dialysis treatment. High number of participants leaving the workforce highlights the challenges related to maintaining employment for patients undergoing dialysis.

Funding

  • Commercial Support