Three-year income trends in Korean adults commencing haemodialysis: A prospective cohort

Aim: This study aimed to explore the trends in individual income and to estimate the change in average monthly income for patients undergoing haemodialysis therapy. Methods: The main data source was the Clinical Research Center (CRC) for End-Stage Renal Disease in Korea. In addition to the cohort data, a survey was conducted to capture personal income for 3 years. To estimate the change in monthly income over time using repeated measures, a random coefficient model using penalized quasi-likelihood methods based on restricted or residual maximum likelihood estimation was used. Results: During the 3-year study period, 138 subjects aged 20 and over who answered the question about pre-dialysis income were traced and analyzed. The median value of monthly income was $US564.4 in the 1 ^st year, $470.4 in the 2 ^nd year, and $733.8 in the 3 ^rd year, representing a 70%, 75%, and 61% decrease compared to pre-dialysis income ($1881.5), respectively. By using mixed analysis, we found that monthly income change was $1283 (95% CI, −1621.5, −945.1), $1182 USD (95% CI, −1540.8, −823.1), and $1041 (95% CI, −1457.6, −623.6) in the 1 ^st , 2 ^nd , and 3 ^rd year, respectively, compared to pre-dialysis income after controlling for other covariates. Women and less educated patients had a relatively higher reduction of income, despite the low starting point. Conclusions: The monthly income of dialysis patients reduced substantially over the study period, especially at the time of the first survey. Considering the social security system, haemodialysis patients face significant personal financial burdens due to their ESRD unrelated to the direct costs of dialysis treatment.