Current treatment status and medical costs for hemodialysis vascular access based on analysis of the Korean Health Insurance Database

Abstract

Background/AimsThe Republic of Korea is a country where the hemodialysis population is growing rapidly. It is believed that the numbers of treatments related to vascular access-related complications are also increasing. This study investigated the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis.MethodsThis was a descriptive observational study. We inspected the insurance claims of patients with chronic kidney disease who underwent hemodialysis between January 2008 and December 2016. We calculated descriptive statistics of the frequencies and medical expenses of procedures for vascular access.ResultsThe national medical expenses for access-related treatment were 7.12 billion KRW (equivalent to 6.36 million USD) in 2008, and these expenses increased to 42.12 billion KRW (equivalent to 37.67 million USD) in 2016. The population of hemodialysis patients, the annual frequency of access-related procedures, and the total medical cost for access-related procedures increased by 1.6-, 2.6-, and 5.9-fold, respectively, over the past 9 years. The frequency and costs of access care increased as the number of patients on hemodialysis increased. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty.ConclusionsThe increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. It is essential to identify the clinical and physiological aspects as well as anatomical abnormalities before planning angioplasty. A timely surgical correction could be a viable option to control the rapid growth of access-related medical expenses.

Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

“…In Korea, the prevalence of ESRD has risen rapidly with the increase of the elderly population [34]. The proportion of ESRD patients on peritoneal dialysis has decreased while that of patients on HD has markedly increased in Korea [13,34]. According to a report from the Korean Society of Nephrology, only approximately 18% of www.krcp-ksn.org the entire population of HD patients in 2016 underwent HDF therapy [35], mainly due to cost problems, and the cost difference between conventional HD and HDF has not been addressed.…”

“…In Korea, the annual number of patients undergoing HD has grown continuously from 49,403 in 2008 to 77,933 in 2016, a 1.57-fold increase [13]. However, few studies have investigated the effects of switching to OL-HDF on various parameters in Korean patients because the cost difference between conventional HD and HDF is not reimbursed in Korea.…”

‘A sword of Damocles’: patient and caregiver beliefs, attitudes and perspectives on presymptomatic testing for autosomal dominant polycystic kidney disease: a focus group study

“… 34 Dialysis in Korea has also been covered since 1989 and this is similar in France. 35 36 In France, genetic testing is not routinely offered to patients, although some could have free access to genetic testing (eg, if they were enrolled in the Genkyst observational cohort study 37 ). In regard to legislative protection, Australia, France and Korea have comprehensive provisions pertaining to consent, autonomy and integrity of the person tested.…”

A Korean perspective on the 2019 Kidney Disease Outcomes Quality Initiative guidelines for vascular access: what has changed and what should be changed in practice?

“…The longevity of HD patients is closely related to the quality of dialysis treatment and depends on reliable and durable vascular access (VA), which is often referred to as the lifeline of HD patients. Furthermore, the medical cost of care for arteriovenous (AV) access continues to increase [ 2 ].…”