Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea
Background : Socioeconomic status is an important factor affecting the accessibility and prognosis of kidney transplantation. We aimed to investigate changes in kidney transplant recipients’ socioeconomic status in South Korea and whether such changes were associated with patient prognosis. Methods...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2023-03-01
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| Series: | Korean Journal of Transplantation |
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| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0049 |
| _version_ | 1827360670913396736 |
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| author | Sehoon Park Jina Park Jihoon Jeong Yunyoung Jang Yong Chul Kim Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Yon Su Kim Hajeong Lee |
| author_facet | Sehoon Park Jina Park Jihoon Jeong Yunyoung Jang Yong Chul Kim Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Yon Su Kim Hajeong Lee |
| author_sort | Sehoon Park |
| collection | DOAJ |
| description | Background : Socioeconomic status is an important factor affecting the accessibility and prognosis of kidney transplantation. We aimed to investigate changes in kidney transplant recipients’ socioeconomic status in South Korea and whether such changes were associated with patient prognosis. Methods : This retrospective nationwide o bservational c ohort s tudy i n S outh Korea included kidney transplant recipients between 2007 and 2016. South Korea provides a single-insurer health insurance service, and information on the socioeconomic status of the recipients is identifiable through the claims database. First, a generalized linear mixed model was used to investigate changes in recipients’ socioeconomic status as an outcome. Second, the risk of graft failure was analyzed using Cox regression as another outcome to investigate whether changes in socioeconomic status were associated with patient prognosis. Results : Among the 15,215 kidney transplant recipients included in the study, economic levels (defined based on insurance fee percentiles) and employment rates declined within the first 2 years after transplantation. Beyond 2 years, the employment rate increased significantly, while no significant changes were observed in economic status. Patients whose economic status did not improve 3 years after kidney transplantation showed a higher risk of death than those whose status improved. When compared to those who remained employed after kidney transplantation, unemployment was associated with a significantly higher risk of death-censored graft failure. Conclusions: The socioeconomic status of kidney transplant recipients changed dynamically after kidney transplantation, and these changes were associated with patient prognosis. |
| first_indexed | 2024-03-08T06:51:41Z |
| format | Article |
| id | doaj.art-0c521546a6754ca8a22230c39dbb6d54 |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T06:51:41Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-0c521546a6754ca8a22230c39dbb6d542024-02-03T06:45:51ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-03-01371294010.4285/kjt.22.0049kjt.22.0049Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South KoreaSehoon Park0Jina Park1Jihoon Jeong2Yunyoung Jang3Yong Chul Kim4Dong Ki Kim5Kook-Hwan Oh6Kwon Wook Joo7Yon Su Kim8Hajeong Lee9Department of Biomedical Science, Seoul National University College of Medicine, Seoul, KoreaDepartment of Biostatistics, Korea University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Biomedical Science, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaBackground : Socioeconomic status is an important factor affecting the accessibility and prognosis of kidney transplantation. We aimed to investigate changes in kidney transplant recipients’ socioeconomic status in South Korea and whether such changes were associated with patient prognosis. Methods : This retrospective nationwide o bservational c ohort s tudy i n S outh Korea included kidney transplant recipients between 2007 and 2016. South Korea provides a single-insurer health insurance service, and information on the socioeconomic status of the recipients is identifiable through the claims database. First, a generalized linear mixed model was used to investigate changes in recipients’ socioeconomic status as an outcome. Second, the risk of graft failure was analyzed using Cox regression as another outcome to investigate whether changes in socioeconomic status were associated with patient prognosis. Results : Among the 15,215 kidney transplant recipients included in the study, economic levels (defined based on insurance fee percentiles) and employment rates declined within the first 2 years after transplantation. Beyond 2 years, the employment rate increased significantly, while no significant changes were observed in economic status. Patients whose economic status did not improve 3 years after kidney transplantation showed a higher risk of death than those whose status improved. When compared to those who remained employed after kidney transplantation, unemployment was associated with a significantly higher risk of death-censored graft failure. Conclusions: The socioeconomic status of kidney transplant recipients changed dynamically after kidney transplantation, and these changes were associated with patient prognosis.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0049kidney transplant; social class; recipient; prognosis; allografts |
| spellingShingle | Sehoon Park Jina Park Jihoon Jeong Yunyoung Jang Yong Chul Kim Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Yon Su Kim Hajeong Lee Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea Korean Journal of Transplantation kidney transplant; social class; recipient; prognosis; allografts |
| title | Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea |
| title_full | Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea |
| title_fullStr | Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea |
| title_full_unstemmed | Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea |
| title_short | Changes in socioeconomic status and patient outcomes in kidney transplantation recipients in South Korea |
| title_sort | changes in socioeconomic status and patient outcomes in kidney transplantation recipients in south korea |
| topic | kidney transplant; social class; recipient; prognosis; allografts |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0049 |
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