Characteristics, Healthcare Utilization, and Medical Expenditures of Home-Based Primary Care Users in Korea

To address the unmet health needs of recipients of the long-term care (LTC) insurance system, a home-based primary care (HBPC) pilot program was introduced in Korea in 2022. This study investigated the characteristics of LTC recipients who used HBPC.

This retrospective study used data from the National Health Insurance Service database. We identified all individuals who were assigned LTC grades from December 2022 to June 2024 (study period) in Korea and classified them according to their HBPC use. A total of 959,182 LTC recipients were included as the study population. Differences in baseline characteristics and healthcare utilization during the study period between HBPC users and non-users were compared. Multivariate logistic regression analysis was performed to evaluate the association between baseline characteristics and HBPC use.

Among the study population, 8,487 (0.9%) were HBPC users and 950,695 (99.1%) were non-users. Emergency room visits were more frequent in HBPC users than in non-users. However, there was no difference in hospitalization rates, and hospitalization-related expenses were lower among HBPC users. Factors associated with HBPC use in the logistic regression analysis were male sex, low income, residing in the Seoul metropolitan region, more severe LTC grade, absence of disability, lower Charlson Comorbidity Index, and presence of dementia or cancer. Additionally, individuals with geriatric syndrome or a higher Multimorbidity Frailty Index were more likely to use HBPC.

This study showed that HBPC is more actively used by LTC recipients with high-need and high-risk; who have a low income; live in the Seoul metropolitan region; and have dementia, cancer, or geriatric syndromes.