Evidence map›Paper›PMID 41386994›Full record

ArticleBMJ open2025

Financial catastrophe and its associated factors among chronic kidney disease patients undergoing haemodialysis in Kathmandu, Nepal: a mixed-method study.

Swastika Poudel, Deepak Kumar Yadav, Vijay Kumar Khanal, Gyanu Nepal Gurung, Sadiksha Pokhrel, Ashok Pudasaini, Ashish Govinda Amatya

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Swastika PoudelSchool of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal poudelswastika12@gmail.com.ORCID http://orcid.org/0009-0007-5290-5839
Deepak Kumar YadavSchool of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Vijay Kumar KhanalBP Koirala Institute of Health Sciences, Dharan, Nepal.ORCID http://orcid.org/0000-0001-7883-9568
Gyanu Nepal GurungSchool of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Sadiksha PokhrelBP Koirala Institute of Health Sciences, Dharan, Nepal.ORCID http://orcid.org/0009-0008-2403-9264
Ashok PudasainiDepartment of Anesthesiology and Critical Care, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
Ashish Govinda AmatyaDepartment of Anesthesiology and Critical Care, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.ORCID http://orcid.org/0000-0002-8370-9511

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe study aimed to assess the prevalence of financial catastrophe and explore patients' perceived effectiveness of the government support programme related to chronic kidney disease.

designCross-sectional mixed-method study.

participantsA total of 120 patients receiving free regular haemodialysis under the government's Deprived Citizen Support Programme for at least 6 months were included in the quantitative study, and 9 patients participated in the qualitative study.

main outcome measuresPrevalence of financial catastrophe and factors associated with financial catastrophe among chronic kidney disease patients undergoing haemodialysis.

methodsA convergent parallel mixed-method approach was carried out from 15 June to 15 December 2024, among chronic kidney disease patients undergoing haemodialysis at the National Kidney Center. Quantitative data were collected through face-to-face interviews using a semi-structured questionnaire. Financial catastrophe was defined as out-of-pocket (OOP) healthcare payments ≥40% of a household's disposable income, following the WHO-recommended threshold for severe financial burden. OOP expenditures were assessed over 6 months, and associations were tested using χ

resultsThe prevalence of financial catastrophe was 72.5%. The factors associated with financial catastrophe were the presence of complications (adjusted OR (AOR): 3.67, 95% CI 1.019 to 13.27), patients without financial support (AOR: 2.77, 95% CI 1.016 to 7.56) and reduction in food expenses (AOR: 0.313, 95% CI 0.109 to 0.896). Qualitative findings on awareness regarding government subsidies, financial strain, barriers to receiving treatment and perceived effectiveness of the programme revealed key aspects of utilisation and effectiveness of the government support programme.

conclusionThe prevalence of financial catastrophe was substantially high, which highlights the importance of addressing economic challenges in chronic kidney disease care. The study emphasised the need to strengthen financial protection through the expansion of government subsidies and improved insurance coverage.

Indexed as

Cost of IllnessFinancial StressHealth ExpendituresRenal DialysisRenal Insufficiency, ChronicAdultAgedCross-Sectional StudiesFemaleFinancing, PersonalHumansMaleMiddle AgedNepalPrevalenceQualitative ResearchHealth Care CostsHEALTH ECONOMICSNepalPUBLIC HEALTH

Identifiers

PMID41386994
PMCPMC12706237

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.