JMIR Publications

ABSTRACT

Background:

There are regional gaps in the access to medical services for patients with chronic kidney disease and it is necessary to reduce those gaps, including those involving medical costs.

Objective:

This study aimed to analyze regional differences in the medical costs associated with chronic kidney disease in the South Korean population.

Methods:

This longitudinal cohort study included participants randomly sampled from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of South Korea. To select those who were newly diagnosed with chronic kidney disease, we excluded those who were diagnosed in 2002–2003 and 2014–2015. A total of 5,903 patients with chronic kidney disease were finally included. We used a marginalized two-part longitudinal model to assess total medical costs.

Results:

Our cohort included 3,495 men and 2,408 women aged 30 to >80 years. Of these, 12.5% (737) and 87.5% (5166) lived in medically vulnerable and non-vulnerable regions, respectively. The post-diagnosis costs showed a significant difference between the regions (estimate: 0.0039, 95% confidence limit:0.0001-0.0078). The difference in medical expenses between the vulnerable and non-vulnerable regions showed an increase each year.

Conclusions:

Patients with chronic kidney disease living in medically vulnerable regions are likely to have higher post-diagnostic medical expenses than those living in regions that are not medically vulnerable. Efforts to improve early diagnosis of chronic kidney disease are needed. Relevant policies should be drafted to decrease the medical costs of patients with chronic kidney disease living in medically deprived areas.