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논문분류	춘계학술대회 초록집
제목	Current Status of Clinical Practice for Hemodialysis Vascular Access in Korea: Observational study based on Korean Health Insurance Database
저자	Hyung Seok Lee, Young Rim Song, Jwa Kyung Kim, Sun ryoung Choi, Na Rae Ju, Hyung Jik Kim, Sung Gyun Kim
출판정보	2018; 2018(1):
키워드	Hemodialysis \| Arteriovenous fistula \| Endovascular procedures \| Angioplasty \| health administrative data
초록	Objectives: In Korea, the number of patients on hemodialysis has rapidly increased. It is believed that the numbers of procedures related to vascular access-related complications are also increasing. This study aimed to investigate the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis. Methods: We investigated the health insurance claims data of the Health Insurance Review and Assessment Service (HIRA), and analyzed the frequency and medical cost of access-related treatment in patients who underwent hemodialysis between 2008 and 2016 in Korea. Results: The number and costs of interventional or surgical procedures for vascular access have increased along with the number of patients on hemodialysis. The medical expenses for vascular access-related treatment were KRW 42 billion in 2016, which accounted for 2.5 percent of the total medical expenses for chronic renal failure treatment. The yearly frequency of access-related procedure has increased by more than 2.6 times over the past nine years, and the growth of the percutaneous transluminal angioplasty was remarkable. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty procedures. Conclusions: The increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. An improved reimbursement benefit for surgical revision would not only improve outcomes by encouraging timely surgical revision but also help to restrain the rapid expansion of angioplasty costs.
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