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

Autor: Hyung Jik Kim, Hyung Seok Lee, Sung Gyun Kim, Pyoungju Park, Young Rim Song, Young-Su Ju, Jwa-Kyung Kim, Narae Joo, Sun Ryoung Choi
Rok vydání: 2018
Předmět:
Male
Time Factors
Databases
Factual
medicine.medical_treatment
030232 urology & nephrology
Disease
Postoperative Complications
0302 clinical medicine
Risk Factors
Health care
030212 general & internal medicine
Child
Arteriovenous fistula
Aged
80 and over
education.field_of_study
Administrative claims
healthcare
Endovascular Procedures
Health Care Costs
Middle Aged
Treatment Outcome
Nephrology
Child
Preschool
Original Article
Female
Hemodialysis
Adult
medicine.medical_specialty
Adolescent
Population
Blood Vessel Prosthesis Implantation
Young Adult
03 medical and health sciences
Arteriovenous Shunt
Surgical
Renal Dialysis
Angioplasty
Republic of Korea
medicine
Humans
Renal Insufficiency
Chronic
education
Device Removal
Aged
business.industry
Infant
Phlebography
medicine.disease
Blood Vessel Prosthesis
Emergency medicine
Observational study
business
Kidney disease
Zdroj: The Korean Journal of Internal Medicine
ISSN: 2005-6648
1226-3303
DOI: 10.3904/kjim.2018.170
Popis: Background/Aims The 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. Methods This 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. Results The 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. Conclusions The 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.
Databáze: OpenAIRE
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