A study conducted in 2021 by the Association of State and Territorial Health Officials (ASTHO), requested by the Palau HealthCare Fund to determine the feasibility of Palau Health Care Insurance coverage of hemodialysis treatment, revealed that 22% or (3,015) of Palau’s adult population have diabetes.

Of the 3,105, 34% or 1,025 are diagnosed, while 66%  or 1,990 are not. Of those diagnosed, 24% are uncontrolled with meds, while only 151 are with meds and controlled, according to the study.

The report also revealed that 1,005 of the diabetes patients had Chronic Kidney Disease, and of those, 443 are most likely to have kidney failure.

In 2019, 55 patients underwent hemodialysis treatment with the cost per treatment of $834 or $80,036 per patient per month.  The total cost of the treatment of the 55 patients is $4.4 million per year.

The conclusion of the study said the future cost of treating the 443 patients with kidney failures per year would be $35.4 million, which the Palau National Health Insurance will not be able to cover.  The total insurance contributions plus income from investments in 2023 was $10.5 million, while the benefit payout (payment for medical care) was $7.3 million, leaving a net balance of only $1.8 million.

Based on the results of the study, it was concluded that it would be unsustainable for the National Health Insurance to cover the cost of hemodialysis treatment.

According to the World Health Organization, diabetes was the direct cause of 1.5 million deaths in 2019, 48% of which occurred in patients younger than 70 years of age.

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