Dataset Information

How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study.

ABSTRACT:

Background

Chronic kidney disease (CKD) poses a financial burden on patients and their households. This descriptive study measures the prevalence of economic hardship and out-of-pocket costs in an Australian CKD population.

Methods

A cross-sectional study of patients receiving care for CKD (stage III-V) in Western Sydney, Australia using a structured questionnaire. Data collection occurred between November 2010 and April 2011. Multivariate analyses assessed the relationships between economic hardship and individual, household and health system characteristics.

Results

The study included 247 prevalent CKD patients. A mean of AUD$907 per three months was paid out-of-pocket resulting in 71% (n=153) of participants experiencing financial catastrophe (out-of-pocket costs exceeding 10% of household income). Fifty-seven percent (n=140) of households reported economic hardship. The adjusted risk factors that decreased the likelihood of hardship included: home ownership (OR: 0.32, 95% CI: 0.14-0.71), access to financial resources (OR: 0.24, 95% CI: 0.11-0.50) and quality of life (OR: 0.12, 95% CI: 0.02-0.56). The factors that increased the likelihood of hardship included if income was negatively impacted by CKD (OR: 4.80, 95% CI: 2.17-10.62) and concessional status (i.e. receiving government support) (OR: 3.09, 95% CI: 1.38-6.91). Out-of-pocket costs and financial catastrophe were not found to be significantly associated with hardship in this analysis.

Conclusions

This study describes the poorer economic circumstances of households affected by CKD and reinforces the inter-relationships between chronic illness, economic well-being and quality of life for this patient population.

SUBMITTER: Essue BM

PROVIDER: S-EPMC3698195 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Publications

How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study.

Essue Beverley M BM Wong Germaine G Chapman Jeremy J Li Qiang Q Jan Stephen S

BMC nephrology 20130110

<h4>Background</h4>Chronic kidney disease (CKD) poses a financial burden on patients and their households. This descriptive study measures the prevalence of economic hardship and out-of-pocket costs in an Australian CKD population.<h4>Methods</h4>A cross-sectional study of patients receiving care for CKD (stage III-V) in Western Sydney, Australia using a structured questionnaire. Data collection occurred between November 2010 and April 2011. Multivariate analyses assessed the relationships betwe ...[more]

PMID: 23305212

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Project description:BackgroundsDyspepsia is a condition that affects 25% of the U.S. population, and, when associated with pyrosis, its prevalence reaches 40%. Patients with chronic renal insufficiency not only present higher circulating levels of gastrin and gastric dysmotilty, but also make use of a great amount of drugs for the treatment of their comorbidities. This situation increases the chances of developing gastrointestinal symptoms. The aim of the current study is to evaluate the dyspeptic disease profile in patients undergoing hemodialysis, comparing them with chronic renal disease patients in conservative treatment and non-renal injury patients.MethodsThis is a cross sectional study performed at the Gastroenterology department at Faculdade de Medicina do ABC in São Paulo, Brazil. Three groups were set aside according to the renal function levels calculated using the simplified MDRD formula. They answered three questionnaires that evaluated the presence of dyspepsia, functional dyspepsia and gastroesophageal reflux disease (GERD) associated with the performance of high digestive endoscopy.ResultsA significant difference between the groups was observed concerning the renal function evaluated by the rates of creatinine clearance, creatinine and urea (p?<?0.001). The rate of dyspepsia in the control group was higher than in patients with renal function alterations (p?=?0.014). There was no difference between groups when it came to the presence of functional dyspepsia and GERD. However, there was a higher use of proton pump inhibitors in the hemodialysis group than in the other groups (p?<?0.001).ConclusionIn the proposed model, there was no positive correlation between the worsening of the renal function and the presence of dyspepsia, functional dyspepsia and GERD. The longitudinal evaluation of hemodialysis patients is hampered by the high mortality rates in this group. There was a higher use of proton pump inhibitors, and it is believed that the dyspeptic symptoms are not acid-related.

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Project description:OBJECTIVES:This study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors. DESIGN, SETTING AND PARTICIPANTS:This cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing. RESULTS:The prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95%?CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95%?CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95%?CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95%?CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95%?CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95%?CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95%?CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95%?CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95%?CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia. CONCLUSION:Anaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care. TRIAL REGISTRATION NUMBER:NMRR-15-660-24324.

Dataset Information

How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study.

Background

Methods

Results

Conclusions

Publications

How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study.

Similar Datasets

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