Financial toxicity and its associated factors in patients requiring maintenance hemodialysis: a multicenter cross-sectional study in China.

Abstract

Background: Financial toxicity is a growing concern for patients requiring Maintenance hemodialysis (MHD), affecting their quality of life and treatment adherence. In economically challenged areas like China's Ningxia Province, patients receiving MHD face increased financial burden due to high dialysis costs, transportation, and lost productivity. Identifying the prevalence and associated factors of financial toxicity is crucial for creating interventions to reduce its impact and improve outcomes of patients.

Methods: A multicenter cross-sectional study in China involved 1,015 patients receiving MHD from four hospitals. Researchers evaluated financial toxicity, social support, and medical coping using COST-PROM, SSRS, and MCMQ scores. Data analysis was performed with Excel 2016 and SPSS 25.0.

Results: The study found a moderate average financial toxicity score of 19.21 ± 4.60. Among participants, 25.5% reported no financial toxicity, 28.4% had mild, and 46.1% experienced moderate financial toxicity. Significant factors related to financial toxicity included monthly household income, medical insurance type, dialysis vintage, number of comorbidities, social support, and coping styles of confrontation and surrender (p < 0.05).

Conclusions: Financial toxicity is common among patients receiving MHD in Ningxia, China, linked to factors like low income, resident medical insurance, number of comorbidities, dialysis vintage, limited social support, and specific coping styles. This highlights the need for targeted interventions. Future studies could explore the value of early support for high-risk patients, regular financial toxicity screening, enhanced social networks, and personalized coping strategies might help alleviate this burden.