Dataset Information

Regional Differences in Medical Costs of Chronic Kidney Disease in the South Korean Population: Marginalized Two-Part Model.

ABSTRACT:

Background

There are regional gaps in the access to medical services for patients with chronic kidney disease (CKD), and it is necessary to reduce those gaps, including the gaps involving medical costs.

Objective

This study aimed to analyze regional differences in the medical costs associated with CKD in the South Korean population.

Methods

This longitudinal cohort study included participants randomly sampled from the National Health Insurance Service-National Sample Cohort of South Korea. To select those who were newly diagnosed with CKD, we excluded those who were diagnosed in 2002-2003 and 2018-2019. A total of 5903 patients with CKD were finally included. We used a marginalized two-part longitudinal model to assess total medical costs.

Results

Our cohort included 4775 (59.9%) men and 3191 (40.1%) women. Of these, 971 (12.2%) and 6995 (87.8%) lived in medically vulnerable and nonvulnerable regions, respectively. The postdiagnosis costs showed a significant difference between the regions (estimate: -0.0152, 95% confidence limit: -0.0171 to -0.0133). The difference in medical expenses between the vulnerable and nonvulnerable regions showed an increase each year after the diagnosis.

Conclusions

Patients with CKD living in medically vulnerable regions are likely to have higher postdiagnostic medical expenses compared to those living in regions that are not medically vulnerable. Efforts to improve early diagnosis of CKD are needed. Relevant policies should be drafted to decrease the medical costs of patients with CKD disease living in medically deprived areas.

SUBMITTER: Park M

PROVIDER: S-EPMC10131872 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Regional Differences in Medical Costs of Chronic Kidney Disease in the South Korean Population: Marginalized Two-Part Model.

Park Minah M Yun Choa C Joo Jae Hong JH Kang Soo Hyun SH Jeong Sung Hoon SH Nam Chung-Mo CM Park Eun-Cheol EC Han Yoondae Y Jang Sung In SI

JMIR public health and surveillance 20230330

<h4>Background</h4>There are regional gaps in the access to medical services for patients with chronic kidney disease (CKD), and it is necessary to reduce those gaps, including the gaps involving medical costs.<h4>Objective</h4>This study aimed to analyze regional differences in the medical costs associated with CKD in the South Korean population.<h4>Methods</h4>This longitudinal cohort study included participants randomly sampled from the National Health Insurance Service-National Sample Cohort ...[more]

PMID: 36995749

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Project description:BackgroundKidney transplantation (KT), a treatment option for end-stage kidney disease (ESKD), is associated with longer survival and improved quality of life compared with dialysis. Inequities in access to KT, and specifically, living donor kidney transplantation (LDKT), have been documented in Canada, along various demographic dimensions. In this article, we review existing evidence about inequitable access to KT and LDKT for patients from communities marginalized by race and ethnicity in Canada.ObjectiveTo characterize the currently published data on rates of KT and LDKT among East Asian, South Asian, and African, Caribbean, and Black (ACB) Canadian communities and to answer the research question, "what factors may influence inequitable access to KT among East Asian, South Asian, and ACB Canadian communities?."Eligibility criteriaDatabases and gray literature were searched in June and November 2020 for full-text original research articles or gray literature resources addressing KT access or barriers in East Asian, South Asian, and ACB Canadian communities. A total of 25 articles were analyzed thematically.Sources of evidenceGray literature and CINAHL, OVID Medline, OVID Embase, and Cochrane databases.Charting methodsLiterature characteristics were recorded and findings which described rates of and factors that influence access to KT were summarized in a narrative account. Key themes were subsequently identified and synthesized thematically in the review.ResultsEast Asian, South Asian, and ACB communities in Canada face barriers in accessing culturally appropriate medical knowledge and care and experience inequitable access to KT. Potential barriers include gaps in knowledge about ESKD and KT, religious and spiritual concerns, stigma of ESKD and KT, health beliefs, social determinants of health, and experiences of systemic racism in health care.LimitationsThis review included literature that used various methodologies and did not assess study quality. Data on ethnicity and race were not reported or defined in a standardized manner. The communities examined in this review are not homogeneous and views on organ donation and KT vary by individual.ConclusionsOur review has identified potential barriers for communities marginalized by race and ethnicity in accessing KT and LDKT. Further research is urgently needed to better understand the barriers and support needs of these communities, and to develop strategies to improve equitable access to LDKT for the growingly diverse population in Canada.

Project description:BackgroundThis study aimed to determine the costs and distribution of healthcare spending of patients with chronic kidney disease (CKD) at stages 3 and 4 and on dialysis both at the individual and population level in Germany.MethodsThe study took the perspective of the German statutory health insurance (SHI) system and analyzed claims data on 3,687,015 insurees from the year 2014. To extrapolate costs to the whole SHI population, a literature search on the prevalence of CKD was conducted.ResultsAverage costs per person per year in an age- and gender-matched control group of the normal population were €2,876 (95% confidence interval [CI], €2,798 to €2,955) and ≥2.8-fold higher in CKD patients (€8,030 [95% CI, €7,848 to €8,212] at CKD stage 3, €9,760 [95% CI, €9,266 to €10,255] at CKD stage 4, and €44,374 [95% CI, €43,608 to €45,139] on dialysis). At CKD stages 3 and 4 the major cost driver was hospitalizations, contributing to more than 50% of total expenditures. Among dialysis patients, hospitalizations and dialysis-treatment costs contributed to 23% and 53% of total healthcare spending, respectively. At CKD stages 3 and 4, patients with the highest 20% of healthcare spending showed a considerable increase in per-patient costs over the reference population, while the bottom 80% of patients generated only moderately higher per-patient costs (p < 0.001). Comparing total CKD costs to total SHI expenditures yields that 10.2% of SHI expenditures was driven by patients at CKD stages 3 and 4 and 1.6% by dialysis patients.ConclusionsHealthcare spending of patients with CKD at stages 3 and 4 and on dialysis is concentrated among a small number of high-need patients. As hospitalizations and dialysis treatment are key drivers of total expenditures, strategies that lead to a reduction in hospitalizations, delay in dialysis onset, or increase in the availability of kidney donors should become important considerations by policymakers.

Dataset Information

Regional Differences in Medical Costs of Chronic Kidney Disease in the South Korean Population: Marginalized Two-Part Model.

Background

Objective

Methods

Results

Conclusions

Publications

Regional Differences in Medical Costs of Chronic Kidney Disease in the South Korean Population: Marginalized Two-Part Model.

Similar Datasets

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