Evaluating integrative medicine acute stroke inpatient care in South Korea

High demand for traditional Korean medicine led to a policy change in 2010 allowing hospitals to provide Integrative medicine care that combines Western medicine and Korean medicine. This study evaluated the effects of Integrative medicine compared to Western medicine-only for managing acute stroke in South Korean hospitals. A retrospective matched case-control observational study was conducted for acute stroke patients admitted nationwide in 2012 and 2013. Propensity score matching was used to adjust for the likelihood of selecting Integrative medicine. Hierarchical generalized linear models were used to control for patient characteristics at the episode of care (level 1) and cluster effects from the hospitals (level 2). A total of 1182 patients and 65 hospitals were matched and analyzed. Receiving Integrative medicine significantly increased the average length of stay (OR 1.27; 95% CI 1.13-1.42), total cost of inpatient care (OR 1.93; 95% CI 1.62-2.31), and per-day cost (OR 1.34; 95% CI 1.21-1.47). Receiving Integrative medicine did not affect all-cause 3-month emergency readmissions (OR 1.36; 95% CI 0.92-2.02). However, Integrative medicine was associated with a reduced risk of all-cause mortality at 3 months (OR 0.36; 90% CI 0.13-0.99) and 12 months (OR 0.34; 95% CI 0.15-0.75) after admission. Receiving Integrative medicine was associated with improved 3-month and 12-month survival, greater healthcare utilization and higher costs. Further economic evaluations are needed to guide policy for efficient integration of Korean medicine and Western medicine.