Household cost and financial coping strategies of dialysis patients at the greater Accra Regional Hospital

Patient financial burden of dialysis treatment is significant, yet dialysis costs remain uncovered under Ghana’s National Health Insurance Scheme (NHIS). This study explores the household costs of dialysis treatment and the financial coping strategies employed by patients and their families at the Greater Accra Regional Hospital.

A cross-sectional study was conducted in September 2023 at the Renal/Dialysis Unit of the Greater Accra Regional Hospital to assess the financial burden on dialysis patients and their caregivers. Data on direct, indirect, intangible costs and financial coping strategies were collected through structured questionnaires in English and local dialects. Descriptive and inferential statistics were used to analyze costs and coping strategies.

The study included 46 patients, of whom 47.8% were male. The total household cost of dialysis during the 30-day study period was GHS 311,848.34 (USD 28,610.00) for all patients. Direct medical costs accounted for 80.8% of total expenditure, with an average dialysis cost of GHS 3,600.00 per patient per 30-day period. Transportation was the highest non-medical cost, averaging GHS 623.90 per patient per month. Indirect costs were mainly driven by productivity losses from missed workdays, totaling GHS 3,848.34 over the study period. Intangible costs were moderate, with 59% of patients reporting depression, anxiety, or social isolation. Patients relied more on informal coping strategies, particularly financial support from friends and family (25%) and reallocating household spending (24%).

Dialysis imposes significant financial burdens on households, particularly through direct medical costs, and is further compounded by intangible costs such as anxiety, depression, and social isolation. Coping strategies primarily rely on informal networks. Policy interventions, such as subsidizing dialysis costs and integrating mental health support into treatment plans, are essential to reduce household financial and emotional strain.