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Financial equity is crucial to ensure economic stability for all. In Korea, individuals registered as legally disabled due to end stage kidney disease (ESKD), requiring kidney transplants or dialysis, can access various welfare benefits, including cost savings on medical treatments and disability allowances. Nevertheless, ESKD patients face the highest medical cost burden relative to their income when compared to other severe illnesses, resulting in lower quality of life (QOL). Therefore, their participation in private finance plans could serve as a viable alternative to supplement inadequacies in public welfare benefits. This study aims to compare private pension and life insurance subscription rates, OOP cost, and income deciles between People with Kidney Disability and those without Disability.
This study used 2009-2016 Korean Health Panel data to analyze adults (18+) in two groups: 131,341 People without Disability and 290 People with Kidney Disability with cost presented in USD based on 2009 exchange rates. In this study, financial equity refers to the private pension insurance and life insurance held by each individual. Annual OOP cost is the sum of annual emergency room, outpatient, and hospitalization cost and prescription drug cost.
The mean age showed a significant difference: People without Disability at 48.9 years and People with Kidney Disability at 61.9 years (p<.0001). Regarding private pension enrollment, 3.6% of People without Disability enrolled, while none of People with Kidney Disability were (p<.0001). Additionally, life insurance enrollment varied, with 18.9% for People without Disability and 2.1% for People with Kidney Disability (p<.0001) (Table 1). The annual OOP cost exhibited a significant difference: People without Disability at $414.1 and People with Kidney Disability at $1,579.2, representing a 3.8 times difference (p<.0001) (Table 2). The means for income decile were different. People with kidney Disability were in the 4.5th, and those without Disability were in higher 6.0th (p<.0001). Additionally, in the lowest 1st decile, People without Disability were at 5.8%, while People with Kidney Disability were at 13.2%, and in the highest 10th decile, People without Disability were at 11.1%, while People with Kidney Disability were at 3.1% (p<.0001) (Table 3).
People with Kidney Disability had higher OOP cost and significantly lower income deciles and private insurance coverage compared to People without Disability. There is a need to consider inclusive finance to improve the QOL of People with Kidney Disabilities.