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Technology-Dependent Children Living at Home in Korea: A Population-Based Analysis Using NHIS Claims Data
Ji Weon Lee1,2, Cho Hee Kim3, Nam Gu Lim4
1Integrated and Respite Care Center for Children, Seoul National University Hospital, Seoul, Korea.
Insights
Technology-dependent children (TDC) require significant healthcare resources, with those having complex chronic conditions (CCC) experiencing longer hospital stays and higher costs. Coordinated home-based care is essential for this growing population.
Area of Science:
- Pediatric Healthcare
- Medical Technology Impact
- Public Health Policy
Background:
- Medical advancements increase survival rates for critically ill children, leading to a rise in technology-dependent children (TDC).
- Understanding the prevalence and healthcare needs of TDC is vital for effective healthcare planning and policy development.
- This study focuses on the prevalence, incidence, and healthcare utilization of TDC in South Korea.
Purpose of the Study:
- To investigate the prevalence and incidence of technology-dependent children (TDC) in South Korea.
- To analyze the healthcare utilization patterns of TDC, including hospital stays, ICU days, and associated costs.
- To compare healthcare utilization between TDC with and without complex chronic conditions (CCC).
Main Methods:
- Retrospective analysis of National Insurance Service claims data from 2018-2019 in South Korea.
- Inclusion criteria: Children aged 0-18 years requiring respiratory or nutritional support at home.
- Estimation of 2-year prevalence, 1-year incidence, and healthcare utilization, with subgroup analysis for CCC status.
Main Results:
- 3,306 TDC identified: 21.5/100,000 for respiratory support, 23.2/100,000 for tube feeding.
- Children with CCC had significantly longer hospital stays (125 vs. 35.8 days) and higher annual costs ($49,870 vs. $10,430).
- Overall 1-year mortality was 17.0%, with increased rates among children with CCC.
Conclusions:
- Technology-dependent children (TDC) represent a small but high-need population requiring substantial healthcare resources.
- Findings underscore the critical need for coordinated, multidisciplinary home-based care for TDC.
- Further research is necessary to inform interventions and policies supporting TDC and their families.
Background:
Advances in medical technology have improved the survival of critically ill children, resulting in a growing population of technology-dependent children (TDC). Given their substantial healthcare needs and often complex care, understanding the prevalence and healthcare utilization of TDC is crucial for informed decision-making for healthcare professionals and policymakers. This study aimed to investigate the prevalence, incidence, and healthcare utilization of TDC in Republic of Korea (South Korea).
Methods:
This retrospective, population-level study analyzed the National Insurance Service claims data in Korea from 2018 to 2019. Children and adolescents aged 0-18 years living at home with technology dependence for respiratory (invasive/non-invasive ventilation, tracheostomy, or oxygen therapy) or nutritional support (nasoenteric or gastrostomy tube feeding) were included. We estimated 2-year prevalence, 1-year incidence, and healthcare utilization, including subgroup comparisons by complex chronic condition (CCC) status.
Results:
In total, 3,306 children were identified as TDC: 1,889 required respiratory support (21.5 per 100,000), and 2,036 required tube feeding (23.2 per 100,000). The mean age was 4.4 ± 5.4 years for respiratory-dependent and 6.2 ± 5.8 years for nutritional-dependent children. Most of the children had ≥ 1 CCC. Compared with non-CCC counterparts, children with CCC had longer hospital stays (125 vs. 35.8 days), more intensive care unit days (74.6 vs. 35.8), and higher annual healthcare costs per patient ($49,870 vs. $10,430). The overall 1-year mortality was 17.0%, with higher rates among patients with CCC.
Conclusion:
TDC represent a relatively small but medically complex population with high healthcare needs and utilization. These findings highlight the importance of coordinated and multidisciplinary home-based care. Further studies are warranted to guide interventions and policies that support improved outcomes for TDC and their families.
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