Korean J Med.  2018 Apr;93(2):194-205. 10.3904/kjm.2018.93.2.194.

Analysis of Hemodialysis Therapy Variation Associated with Periodic Hemodialysis Quality Assessment by Government in Korea

  • 1Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea. jindongc@catholic.ac.kr
  • 2Korean Health Insurance Review and Assessment Service, Wonju, Korea.


The appropriateness assessment of hemodialysis therapy by Korean Health Insurance Review & Assessment service was conducted five times. The purpose of this study was to analyze the effect of the appropriateness assessment on the clinical hemodialysis treatment through the analysis of the medical expenses.
The medical insurance claims during the three months before and after the second, third, and fourth appropriateness assessment and the patient survival rate were analyzed according to the appropriateness rating level.
The medical costs per patient during the three months before and after the assessment period were 6 to 8% lower than that of the assessment period. The medication cost (drug fee) was the best part of the evaluation because the cost differences according to the appropriateness rating grade were obvious. In addition, the cost of erythropoietin gradually decreased over each evaluation period, but there was no cost decrease in other drugs and the diabetic drug was even slightly increased. Patient survival rate according to the appropriateness rating grade was not large, but grade 2 was the best which was followed by grade 1 and grade 3, 4, and 5 were almost the same. Patient survival rate according to the appropriateness rating grade was not significant.
The variation of medical costs associated with the assessment implicates the necessity of all year-round assessment. In addition, drug costs among the medical expenses seem to be the best reflected part of the evaluation grade because of the difference.


Renal dialysis; Costs and cost analysis; Health impact assessment

MeSH Terms

Costs and Cost Analysis
Drug Costs
Health Impact Assessment
Insurance, Health
Renal Dialysis*
Survival Rate
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