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Disparities in Kidney Transplantation Access among Korean Patients Initiating Dialysis: A Population-Based Cohort Study Using National Health Insurance Data (2003-2013)

Authors
 YoungChoi  ;  JaeyongShin  ;  JungTakPark  ;  KyoungHeeCho  ;  Eun-CheolPark  ;  TaeHyunKim 
Citation
 AMERICAN JOURNAL OF NEPHROLOGY, Vol.45(1) : 32-39, 2017 
Journal Title
AMERICAN JOURNAL OF NEPHROLOGY
ISSN
 0250-8095 
Issue Date
2017
MeSH
Adult ; Databases, Factual ; Female ; Health Services Accessibility* ; Healthcare Disparities* ; Humans ; Income* ; Kidney Failure, Chronic/therapy* ; Kidney Transplantation* ; Male ; Middle Aged ; Renal Dialysis* ; Republic of Korea ; Social Class*
Keywords
End-stage renal disease ; Kidney transplantation ; Socioeconomic status
Abstract
BACKGROUND: The socioeconomic status of a person has an impact on his or her access to kidney transplantation as has been reported in western countries. This study examined the association between income level and kidney transplantation among chronic kidney disease patients undergoing dialysis in South Korea.

METHODS: We analyzed data from 1,792 chronic kidney disease patients undergoing dialysis and listed in the Korean National Health Insurance Claim Database (2003-2013). The likelihood of receiving the first kidney transplant over time was analyzed using competing risk proportional hazard models on time from initiating dialysis to receiving a transplant.

RESULTS: Of 1,792 patients on dialysis, only 184 patients (10.3%) received kidney transplants. Patients with medical aid had the lowest kidney transplantation rate (hazard ratio 0.29, 95% CI 0.16-0.51). A lower income level was significantly associated with a low kidney transplantation rate, after adjusting for covariates, compared to patients in the high-income level group.

CONCLUSIONS: Our findings indicate that in South Korea, the total number of kidney transplants is remarkably low and there exists income disparity with regard to access to kidney transplantation. Thus, we suggest that plans be implemented to encourage organ donation and increase organ transplant accessibility for all patients irrespective of their socioeconomic status.
Full Text
https://www.karger.com/Article/FullText/450979
DOI
10.1159/000450979
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Shin, Jae Yong(신재용) ORCID logo https://orcid.org/0000-0002-2955-6382
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/153326
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