The Impact of Socioeconomic Factors on the Prevalence of Hemodialysis in Mainland China.

Objective: The prevalence of hemodialysis varies significantly across countries and regions with different levels of socioeconomic development. This paper aims to analyze the socioeconomic factors influencing hemodialysis in mainland China, providing a basis for formulating reasonable hemodialysis strategies.

Methods: All the hemodialysis prevalence data and socioeconomic data were obtained from the National Medical Service and Quality Safety Report and the China Statistical Yearbook. The 31 regions were categorized into low, medium, and high groups based on the per capita gross domestic product, and the changes in hemodialysis prevalence rates and their growth rates were compared. Linear regression analysis was conducted to identify the independent risk factors affecting hemodialysis prevalence rates.

Results: Significant differences in hemodialysis prevalence rates were observed across different years and per capita gross domestic product groups (p < 0.001). The prevalence of hemodialysis in the low and medium per capita gross domestic product groups significantly increased from 2011 to 2020 (p < 0.001), while an increase in the high per capita gross domestic product group was not statistically significant (p > 0.05). The growth in hemodialysis prevalence rates over the 10-year period decreased with increasing per capita gross domestic product levels in 2011 (325.2% ± 98.6%, 209.3% ± 61.9%, and 52.6% ± 73.7% for the low, medium, and high per capita gross domestic product groups, respectively). The incidence of hemodialysis, per capita gross domestic product, the proportion of rural-urban population, highway mileage per square kilometer, and the number of beds in medical facilities per 1000 population were identified as independent factors of hemodialysis prevalence rates (p < 0.05).

Conclusions: With the development of the social economy and the enhancement of medical service capabilities, the prevalence of hemodialysis in Mainland China has increased. Compared to economically less developed and moderately developed regions, the increase in hemodialysis prevalence in economically developed areas has been attenuated.