Overall Improvement in Domestic Primary Care Quality Over 12 Years... Disease and Income Disparities Persist

by Lee Gwanju

Published 15 Nov.2022 08:23(KST)

Seoul National University Bundang Hospital Family Medicine Professor Lee Hyejin's Team
Study on Hospitalization Rates for 'Outpatient Care Sensitive Conditions' from 2008 to 2019
Decrease in Hypertension, Diabetes, Chronic Obstructive Pulmonary Disease, and Asthma
Increase in Pneumonia and Urinary Tract Infections... Hospitalization Rate for Beneficiaries Tripled

Professor Lee Hye-jin of the Department of Family Medicine at Bundang Seoul National University Hospital (from the left), Professor Lee Jin-yong of the Public Care Center at Seoul National University Hospital, and Researcher Park Hye-gi of the Health Insurance Review and Assessment Service.

[Asia Economy Reporter Lee Gwan-joo] A study has found that although the overall quality of primary care in South Korea has improved over the past decade, disparities exist depending on income and disease.

The research team led by Professor Lee Hye-jin of the Department of Family Medicine at Bundang Seoul National University Hospital (including Professor Lee Jin-yong of Seoul National University Hospital Public Care Center and Researcher Park Hye-gi from the Health Insurance Review and Assessment Service) announced on the 15th that they confirmed this by studying 12 years of trends and risk factors for hospitalizations due to Ambulatory Care Sensitive Conditions (ACSC).

ACSC refers to diseases for which timely and effective outpatient medical services can prevent disease occurrence or, in cases where the disease has already developed, early treatment and management can reduce the likelihood of hospitalization. Therefore, the ACSC hospitalization rate is used as an indicator to roughly evaluate a country's primary care. Representative diseases include hypertension, diabetes, pulmonary diseases, asthma, pneumonia, and urinary tract infections. By examining hospitalization rates for these diseases, one can assess both the quality of primary care and the efficient use of healthcare service resources.

The research team conducted the study by analyzing all patients (12,324,071 individuals) who used ACSC medical services from 2008 to 2019 using big data from the Health Insurance Review and Assessment Service, categorizing them by disease, income level, age, and other factors. As a result, the ACSC hospitalization rate decreased from 5.0% in 2008 to 4.2% in 2019. By disease, hospitalization rates for hypertension, diabetes, chronic obstructive pulmonary disease, and asthma decreased, whereas hospitalization rates for pneumonia and urinary tract infections increased. Hospitalization rates for heart failure decreased until 2012 but showed an increasing trend thereafter. Additionally, by income level, the ACSC hospitalization rate for medical aid recipients was 12.2%, higher than that of health insurance subscribers (3.7%). Elderly individuals aged 65 and older had hospitalization rates ranging from at least 1.1 times to as much as 4.7 times higher than those aged 19 to 44, depending on the disease.

Regarding this, the research team explained that while the overall quality of primary care in South Korea has improved, the increasing trends in pneumonia, urinary tract infections, and heart failure indicate an aging society. Furthermore, medical aid recipients face a higher financial burden compared to health insurance subscribers, leading to lower continuity of care, which in turn results in higher hospitalization rates due to disease worsening. Professor Lee Hye-jin stated, "The analysis of ACSC hospitalization rates shows that the quality of primary care has improved," but added, "However, since there are significant differences in hospitalization rates by disease and income level, it is necessary to improve the quality of primary care through comprehensive and continuous management utilizing the primary care physician system."