대한신장학회

논문분류	춘계학술대회 초록집
제목	Sociodemographic Characteristics, Out-of-pocket Expenditure, and Catastrophic Health Expenditure between Disabilities with Dialysis and those with Kidney Transplant due to End Stage Kidney Disease: Based on the Korean Health Panel
저자	Hee Woo Lee
출판정보	2026; 2026(1):
키워드	End-stage kidney disease, Kidney disability, Dialysis, Kidney transplantation, Out-of-pocket expenditure
초록	Objectives: This study compared sociodemographic characteristics and financial burdens between registered persons with kidney disabilities based on treatment modality: dialysis and kidney transplantation (KT). We tested three hypotheses: (1) those with dialysis-related disabilities face greater sociodemographic vulnerability, (2) their out-of-pocket (OOP) expenditures are higher, and (3) their prevalence of catastrophic health expenditure (CHE) is higher than the KT group. Methods: We analyzed 10 years of longitudinal data (2009–2018) from the Korea Health Panel, extracting 282 observations of registered persons with kidney disabilities. Household income and expenses were equivalized by size. CHE was defined as OOP medical expenditures exceeding 40% of the household's capacity-to-pay. Results: Hypotheses 1 and 2 were supported, while Hypothesis 3 was rejected. Among 282 observations (83.3% dialysis and 16.7% kidney transplant), the dialysis group showed significantly higher sociodemographic vulnerability (p < .05). They were older (62.9 vs 56.7 years), had higher rates of living without a spouse (34.0% vs 14.9%), higher economic inactivity (89.4% vs 74.5%), and were more likely to be in the lowest income quintile (39.7% vs 12.8%). They also had more comorbidities (5.1 vs 4.2). After adjusting for these sociodemographic covariates, annual out-of-pocket expenditure remained significantly higher for the dialysis group (1,999 USD) than the kidney transplant group (1,038 USD). However, despite the higher raw percentage of catastrophic health expenditure in the dialysis group (65.5% vs 39.6%), no statistically significant difference was found. Conclusion: Registered persons with dialysis-related disabilities exhibit significantly worse sociodemographic profiles and higher OOP expenditures compared to those with KT. These results suggest that current health and welfare policies should be re-evaluated to determine whether the provision of differential benefit structures is a reasonable and necessary policy intervention.
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