Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Sally Willis


AbstractChronic kidney disease (CKD) is a significant cause of disability and death in Saint Lucia. The incidence of CKD is disproportionately higher among individuals who are socially and financially disadvantaged. New evidence suggests that in resource-poor countries, government subsidization programs for dialysis treatment aid in the delay of disease progression and its associated costs. The purpose of this study was to examine the relationship between health insurance, government subsidization, employment, and dialysis utilization for CKD patients and the efficacy of subsidization for dialysis in Saint Lucia. The study included a retrospective cohort of 979 moderate-to-severe CKD patients from secondary data obtained from the Ministry of Health’s renal registry database. Dialysis utilization among CKD patients was compared to usage across payment methods. Categorical data were measured and compared using crosstabulations, chi-square analyses, frequency distributions, and counts between groups. Logistic regression was applied to control for covariates and compare independent variables. A statistically significant relationship was found between employment and subsidization and dialysis utilization among CKD patients but not between insurance and dialysis utilization. Dialysis utilization among CKD patients in Saint Lucia was heavily influenced by government subsidization. Policy makers, healthcare officials, and other stakeholders may obtain information from this study that they can use to develop future initiatives for payment models and disease management of CKD in Saint Lucia, which may alleviate some of the financial barriers faced by the country’s CKD patients.