The burden of end-stage renal disease in Khartoum, Sudan: cost of illness study

Background and purposeThe 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.Materials and methodsThis 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).ResultsThis 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.Conclusion and limitationsOur 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. As medical care costs continue to rise in Sudan, this study aimed to estimate direct and indirect costs associated with end-stage renal disease (ESRD) from the patient's perspective. Accurate information on the cost of illness (COI) helps policymakers prioritize healthcare services and resources, optimize public well-being, and determine health policy effectiveness. Future research should include a longitudinal design and understand ESRD costs from caregivers' and healthcare providers' perspectives.