{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:05:46Z","timestamp":1785906346071,"version":"3.56.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cost Eff Resour Alloc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The treatment of kidney disease, including hemodialysis, poses challenges in healthcare and finances. Despite limited data on hemodialysis costs and determinants in Ethiopia, existing literature indicates a paucity of evidence regarding the economic burden of hemodialysis. This study aims to evaluate the direct and indirect costs of hemodialysis among end-stage renal disease (ESRD) patients, alongside associated factors, among selected governmental and private institutions in Addis Ababa, Ethiopia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>An institutional-based cross-sectional study using a simple random sampling technique was conducted from September 10 to November 1, 2021. One hundred twenty-eight patients participated in the study. Data was collected using an interviewer-administered questionnaire. The analysis used proportion and frequency measures of central tendency and linear regression measures. Both simple and multiple linear regression models were used to assess associated factors. The final model used a P value\u2009&lt;\u20090.05 at 95% confidence interval (CI) was used to determine significance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Result<\/jats:title>\n                <jats:p>The mean cost of hemodialysis in a representative sample of selected hospitals in Addis Ababa was 7,739.17 $ \u00b12,833.51 $, with direct medical cost contributing 72.9% of the total cost. Furthermore, the institution type (private or public) and duration on hemodialysis were associated with an increased cost of hemodialysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our findings underline the necessity for policymakers, program administrators, and healthcare institution executives to prioritize this group, recognizing the substantial load they bear and extending these services in government facilities to a broader patient population.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12962-024-00530-7","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T15:02:27Z","timestamp":1712242947000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The economic burden of hemodialysis and associated factors among patients in private and public health facilities: a cross-sectional study in Addis Ababa, Ethiopia"],"prefix":"10.1186","volume":"22","author":[{"given":"Tiruneh Amsalu","family":"Baye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamelmal","family":"Gebeyehu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahteme","family":"Bekele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semira","family":"Abdelmenan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigistu Adamu","family":"Ashengo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berhanu","family":"Mengistu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"issue":"1","key":"530_CR1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12882-021-02628-z","volume":"23","author":"C Ke","year":"2022","unstructured":"Ke C, et al. Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990\u20132019: results from the global burden of disease study 2019. BMC Nephrol. 2022;23(1):1\u201312.","journal-title":"BMC Nephrol"},{"issue":"1","key":"530_CR2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","volume":"12","author":"CP Kovesdy","year":"2022","unstructured":"Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Supplements. 2022;12(1):7\u201311.","journal-title":"Kidney Int Supplements"},{"issue":"1","key":"530_CR3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.5414\/CNP92S101","volume":"93","author":"FA Arogundade","year":"2020","unstructured":"Arogundade FA, et al. Burden of end-stage renal disease in sub-saharan Africa. Clin Nephrol. 2020;93(1):3\u20137.","journal-title":"Clin Nephrol"},{"issue":"10225","key":"530_CR4","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/S0140-6736(19)32977-0","volume":"395","author":"P Cockwell","year":"2020","unstructured":"Cockwell P, Fisher L-A. The global burden of chronic kidney disease. Lancet. 2020;395(10225):662\u20134.","journal-title":"Lancet"},{"key":"530_CR5","unstructured":"Disease N. I.o.D.a.D.a.K. Hemodialysis. 2023 [cited 2023 February 20, 2023]; Available from: https:\/\/www.niddk.nih.gov\/health-information\/kidney-disease\/kidney-failure\/hemodialysis."},{"key":"530_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-015-1166-8","volume":"15","author":"L Mushi","year":"2015","unstructured":"Mushi L, Marschall P, Fle\u00dfa S. The cost of dialysis in low and middle-income countries: a systematic review. BMC Health Serv Res. 2015;15:1\u201310.","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"530_CR7","doi-asserted-by":"publisher","first-page":"e039653","DOI":"10.1136\/bmjopen-2020-039653","volume":"11","author":"F Yang","year":"2021","unstructured":"Yang F, et al. Cost-effectiveness analysis of renal replacement therapy strategies in Guangzhou city, southern China. BMJ open. 2021;11(2):e039653.","journal-title":"BMJ open"},{"key":"530_CR8","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1007\/s41669-019-0124-5","volume":"3","author":"L Makhele","year":"2019","unstructured":"Makhele L, et al. A cost analysis of haemodialysis and peritoneal dialysis for the management of end-stage renal failure at an academic hospital in Pretoria, South Africa. PharmacoEconomics-open. 2019;3:631\u201341.","journal-title":"PharmacoEconomics-open"},{"issue":"1","key":"530_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13561-015-0064-4","volume":"5","author":"L Mushi","year":"2015","unstructured":"Mushi L, Krohn M, Flessa S. Cost of dialysis in Tanzania: evidence from the provider\u2019s perspective. Health Econ Rev. 2015;5(1):1\u201310.","journal-title":"Health Econ Rev"},{"key":"530_CR10","unstructured":"Elsharif ME, GARIBALLA EE. and M. GADOUR, Costs of Hemodialysis and Kidney Transplantation in Sudan A Single Center Experience 2010."},{"issue":"1","key":"530_CR11","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1111\/hdi.12895","volume":"25","author":"AO Yousif","year":"2021","unstructured":"Yousif AO, et al. Out-of\u2010pocket payments by end\u2010stage kidney disease patients on regular hemodialysis: cost of illness analysis, experience from Sudan. Hemodial Int. 2021;25(1):123\u201330.","journal-title":"Hemodial Int"},{"key":"530_CR12","doi-asserted-by":"crossref","unstructured":"Kassa DA, et al. Cost of hemodialysis treatment and associated factors among end-stage renal disease patients at the tertiary hospitals of Addis Ababa City and Amhara Region, Ethiopia. ClinicoEconomics and Outcomes Research; 2020. pp. 399\u2013409.","DOI":"10.2147\/CEOR.S256947"},{"issue":"9","key":"530_CR13","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1093\/heapol\/czaa085","volume":"35","author":"O Paltiel","year":"2020","unstructured":"Paltiel O, et al. A public\u2013private partnership for dialysis provision in Ethiopia: a model for high-cost care in low-resource settings. Health Policy Plann. 2020;35(9):1262\u20137.","journal-title":"Health Policy Plann"},{"key":"530_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-020-4960-x","volume":"20","author":"H Zhang","year":"2020","unstructured":"Zhang H, et al. Direct medical costs of end-stage kidney disease and renal replacement therapy: a cohort study in Guangzhou City, southern China. BMC Health Serv Res. 2020;20:1\u201314.","journal-title":"BMC Health Serv Res"},{"issue":"Suppl 2","key":"530_CR15","first-page":"70","volume":"18","author":"NK Surendra","year":"2018","unstructured":"Surendra NK, et al. The cost of dialysis in Malaysia: haemodialysis and continuous ambulatory peritoneal dialysis. Malaysian J Public Health Med. 2018;18(Suppl 2):70\u201381.","journal-title":"Malaysian J Public Health Med"},{"issue":"3","key":"530_CR16","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.kint.2018.03.028","volume":"94","author":"M Shaikh","year":"2018","unstructured":"Shaikh M, et al. Utilization, costs, and outcomes for patients receiving publicly funded hemodialysis in India. Kidney Int. 2018;94(3):440\u20135.","journal-title":"Kidney Int"},{"issue":"1","key":"530_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-022-08151-7","volume":"22","author":"A Debie","year":"2022","unstructured":"Debie A, Khatri RB, Assefa Y. Contributions and challenges of healthcare financing towards universal health coverage in Ethiopia: a narrative evidence synthesis. BMC Health Serv Res. 2022;22(1):1\u201316.","journal-title":"BMC Health Serv Res"}],"container-title":["Cost Effectiveness and Resource Allocation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12962-024-00530-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12962-024-00530-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12962-024-00530-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T11:58:40Z","timestamp":1717588720000},"score":1,"resource":{"primary":{"URL":"https:\/\/resource-allocation.biomedcentral.com\/articles\/10.1186\/s12962-024-00530-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,4]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["530"],"URL":"https:\/\/doi.org\/10.1186\/s12962-024-00530-7","relation":{},"ISSN":["1478-7547"],"issn-type":[{"value":"1478-7547","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,4]]},"assertion":[{"value":"31 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethical clearance was obtained from The Addis Continental Institute of public health ethical review board (Ref no.: ACIPH-MPH\/068\/63). Consequently, formal letter was issued to the selected hospitals. Before data collection, this review was followed by a second ethical review from St. Paul\u2019s Hospital millennium medical college Institutional Review Board. Furthermore, written informed consent was obtained from each participant before the actual data collection. The confidentiality and anonymity of study participants were safeguarded throughout the study by using a personal identifier and limiting accesses to data after data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and informed consent"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"25"}}