TY - JOUR
T1 - Healthcare utilization and expenditure among individuals with end-stage kidney disease in Taiwan
AU - Lee, Chia Chun
AU - Hsu, Chih Cheng
AU - Lin, Ming Huang
AU - Sung, Junne Ming
AU - Kuo, Te Hui
N1 - Funding Information:
We thank the Taiwan Society of Nephrology for providing funding support for data acquisition and analysis.
Publisher Copyright:
© 2021 Formosan Medical Association
PY - 2022/2
Y1 - 2022/2
N2 - Background/Purpose: The prevalence of end-stage kidney disease (ESKD) in Taiwan has been increasing in recent decades. ESKD care and medical expenditures constitute an important part of the entire healthcare system. Methods: This study analyzed data collected from the National Health Insurance (NHI) Research Database from 2010 to 2018. Results: The annual medical cost increased by approximately 4% both in the entire Taiwanese population and in its ESKD population. The total medical expenditure in the ESKD population from 2010 to 2018 increased from 48.03 to 65.65 billion reimbursement points, with dialysis treatments costing higher than non-dialysis treatments. ESKD outpatient and inpatient costs accounted for 10.4%–11.1% and 4.8%–5.6% of the entire NHI expenditure, respectively. The leading cause of inpatient costs was circulatory diseases, accounting for 29.3% of the total ESKD inpatient costs in 2018. Furthermore, percutaneous coronary intervention had the highest cost followed by simple percutaneous transluminal angioplasty. In 2018, the hemodialysis population had the highest average monthly cost of 73 thousand points per person, while the kidney transplant population had the lowest average monthly cost of 39 thousand points per person. Conclusion: Medical expenditure, including both inpatient and outpatient costs, of the ESKD population continued to grow from 2010 to 2018. The non-dialysis cost in the ESKD population was mainly for cardiovascular disease management and vascular access care, for which prevention will always be challenging.
AB - Background/Purpose: The prevalence of end-stage kidney disease (ESKD) in Taiwan has been increasing in recent decades. ESKD care and medical expenditures constitute an important part of the entire healthcare system. Methods: This study analyzed data collected from the National Health Insurance (NHI) Research Database from 2010 to 2018. Results: The annual medical cost increased by approximately 4% both in the entire Taiwanese population and in its ESKD population. The total medical expenditure in the ESKD population from 2010 to 2018 increased from 48.03 to 65.65 billion reimbursement points, with dialysis treatments costing higher than non-dialysis treatments. ESKD outpatient and inpatient costs accounted for 10.4%–11.1% and 4.8%–5.6% of the entire NHI expenditure, respectively. The leading cause of inpatient costs was circulatory diseases, accounting for 29.3% of the total ESKD inpatient costs in 2018. Furthermore, percutaneous coronary intervention had the highest cost followed by simple percutaneous transluminal angioplasty. In 2018, the hemodialysis population had the highest average monthly cost of 73 thousand points per person, while the kidney transplant population had the lowest average monthly cost of 39 thousand points per person. Conclusion: Medical expenditure, including both inpatient and outpatient costs, of the ESKD population continued to grow from 2010 to 2018. The non-dialysis cost in the ESKD population was mainly for cardiovascular disease management and vascular access care, for which prevention will always be challenging.
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U2 - 10.1016/j.jfma.2021.12.010
DO - 10.1016/j.jfma.2021.12.010
M3 - Article
C2 - 34980549
AN - SCOPUS:85122139087
SN - 0929-6646
VL - 121
SP - S47-S55
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
ER -