Evidence of Overlapping Roles Between Clinics and Hospitals in Primary Care

Area of Science:

• Healthcare policy
• Primary care research
• Health services research

Background:

• Clinics and hospitals in South Korea are often perceived as competitors.
• This study examines the overlapping roles in primary care provision between clinics and hospitals.
• Analysis focuses on initial diagnoses of hypertension (HTN) and diabetes mellitus (DM).

Purpose of the Study:

• To analyze the healthcare facility type where patients first receive diagnoses of HTN or DM.
• To explore patient characteristics influencing healthcare facility choice.
• To compare healthcare utilization patterns in the first year post-diagnosis by facility type.

Main Methods:

• Utilized 2021 claims data from the Health Insurance Review and Assessment Service.
• Included data from 599,955 newly diagnosed HTN patients and 195,668 newly diagnosed DM patients.
• Analyzed diagnosis distribution, patient characteristics, healthcare utilization, and continuity of care.

Main Results:

• Clinics diagnosed 82.5% of HTN and 66.6% of DM cases; hospitals diagnosed the remainder.
• Younger patients, those with comorbidities, and non-Seoul residents were more likely to use hospitals.
• Clinic-diagnosed patients had higher visit frequency and total medical expenses but better continuity of care.

Conclusions:

• Both clinics and non-general hospitals significantly contribute to primary care.
• Strengthening clinic-based primary care and ensuring hospital primary care quality are crucial.
• Policies promoting transparency in quality assessments can aid patient decision-making.