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Abstract: PO1124

Low Socioeconomic Status Increases Risk of Mortality and Hospitalization in Korean Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Noh, Jung Woo, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Park, Hayne C., Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Kwon, Young Eun, Myongji Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
  • Kim, Do Hyoung, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Cho, Ajin, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Kim, Juhee, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Yun, Kyu Sang, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Lee, Youngki, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)
Background

The number of hemodialysis (HD) patients and medical expenses are growing rapidly in Korea owing to aging society and accompanying diseases such as diabetes. Whether low socioeconomic status (SES) affects poorer HD outcome is controversial. Therefore, this study was performed to evaluate the effect of SES upon mortality and hospitalization in Korean maintenance HD patients.

Methods

We used HD quality assessment data from the year of 2013 and 2015 for collecting demographic and clinical data. The mortality data was collected until Dec 2017. We used insurance status as a proxy indicator of SES in which the subjects were classified into low SES (Medical Aid recipients) and high SES (National Health Insurance beneficiary). We analyzed mortality and hospitalization risk based on SES using Cox proportional hazard model.

Results

A total of 21,786 HD patients from 2013 survey and 35,454 HD patients from 2015 survey were included in the analysis. The ratio between high and low SES group was 76.7% versus 23.3%. The low SES group was younger and showed higher proportion of male, and lower proportion of diabetes, hypertension, and cerebrovascular accidents compared to the high SES group. The crude mortality rate was 93/1,000 person-year in 2013 and 106/1,000 person-year in 2015. After adjusting for age, gender, comorbidity and laboratory parameters, the low SES group showed significantly higher mortality risk compared to the high SES group (hazard ratio 1.151 [95% confidence interval (CI) 1.082-1.225], P < 0.0001 in 2013 survey and hazard ratio 1.073 [95% CI 1.009-1.14], P = 0.0254 in 2015 survey). The low SES group was also an independent risk factor for hospitalization after adjusting for age, gender, comorbidity and parameters (hazard ratio 1.129 [95% CI 1.09-1.17], P < 0.0001 in 2013 survey and hazard ratio 1.142 [95% CI 1.108-1.178], P < 0.0001 in 2015 survey).

Conclusion

Low SES independently increases risk of patient mortality and hospitalization in Korean maintenance HD patients