The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Current treatment status and medical costs for hemodialysis vascular access based on analysis of the Korean Health Insurance Database

  • Lee, Hyung Seok (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Ju, Young-Su (Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital) ;
  • Song, Young Rim (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Kim, Jwa Kyung (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Choi, Sun Ryoung (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Joo, Narae (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Kim, Hyung Jik (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Park, Pyoungju (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital) ;
  • Kim, Sung Gyun (Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital)
  • Received : 2018.05.12
  • Accepted : 2018.07.24
  • Published : 2018.11.01
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Abstract

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.

Keywords

Acknowledgement

Supported by : Hallym University

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