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

Authors
 Minah Park  ;  Choa Yun  ;  Jae Hong Joo  ;  Soo Hyun Kang  ;  Sung Hoon Jeong  ;  Chung-Mo Nam  ;  Eun-Cheol Park  ;  Yoondae Han  ;  Sung In Jang 
Citation
 JMIR PUBLIC HEALTH AND SURVEILLANCE, Vol.9 : e39904, 2023-03 
Journal Title
 JMIR PUBLIC HEALTH AND SURVEILLANCE 
Issue Date
2023-03
MeSH
Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Male ; Renal Insufficiency, Chronic* / complications ; Renal Insufficiency, Chronic* / epidemiology ; Renal Insufficiency, Chronic* / therapy ; Republic of Korea / epidemiology
Keywords
chronic disease ; chronic kidney disease ; cost ; cost analysis ; economic ; insurance ; kidney ; longitudinal model ; medical expenses ; medically vulnerable regions ; public health ; regional
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.
Files in This Item:
T202302601.pdf Download
DOI
10.2196/39904
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/194207
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