[Inside Chodong] Super-Aged Society: Home Visit Medical Services Must Be Expanded

The era of living to 100 years old is approaching. As society becomes super-aged, the number of elderly people who find it difficult to use hospitals increases. Local governments nationwide, except for the metropolitan area, face a severe shortage of medical resources. Accessibility to medical institutions is also a problem. Increasing medical school quotas and hospitals alone cannot solve the issue. For patients with mobility difficulties to visit hospitals, they must request transportation such as ambulances or have caregivers bring them. For elderly patients living alone, hospital visits are a distant dream. Is there a way to reduce medical expenses while improving accessibility? Home visits, where medical staff visit patients' residences to provide medical services, can be an alternative.

Japan, which entered a super-aged society earlier than Korea, has a well-established medical system for the elderly. Japan encourages home medical care by setting additional fees based on emergency, nighttime, holiday house calls, whether death diagnosis is performed, and consultation hours. There is also a home medical bed system where hospital rooms in home-type medical centers are decorated like homes to enable daily living. When an emergency patient arises at a home medical center, contracted local hospital doctors provide treatment, keeping operating costs low. The Korean government also provides medical services through a pilot project for long-term care home medical centers. The government is promoting policies supporting home visit medical fees by introducing nighttime and holiday fees, easing co-payment rates for socially vulnerable groups such as the elderly, and proposing measures to encourage service use. However, these efforts are still insufficient to satisfy patients.

A study estimating the need for home visits using 2018 data from the National Health Insurance Service medical panel shows that 12.1% of urban residents and 14.2% of rural residents require home visit medical care. According to data from the National Assembly Legislative Research Office, as of last March, the number of patients receiving home visit medical services was 10,598 in Western medicine and 2,976 in Korean medicine. It is necessary to consider expanding supply to induce actual participation of home visit clinics.

Home nursing services should also be expanded. Home nursing involves nurses and other long-term care personnel visiting homes according to doctors' or Korean medicine doctors' home nursing orders to provide nursing, assistance with medical care, and counseling. In Japan, home nursing services are already well established. Japanese home nursing is a fundamental yet specialized medical service that supports elderly people to live safely in their desired homes without entering facilities. It is a comprehensive service ranging from daily living support and preventive services to end-of-life care, integrated with various types of community-based services such as home medical care, regular patrols and on-demand responses, and small-scale multifunctional nursing services. The average age of home nursing users is over 82 years old. The most common diseases were cerebrovascular disease (15.4%), musculoskeletal disorders (9.0%), dementia (8.6%), malignant neoplasms (8.3%), and heart disease (6.0%).

Korea’s elderly long-term care insurance beneficiaries are elderly patients with chronic diseases who have high demands not only for assistance with daily living but also for health care services, yet they cannot sufficiently use medical services due to mobility difficulties. Home nursing benefits, the only health care service among home care benefits, are evaluated to reduce the frequency of medical institution visits by home care beneficiaries and positively impact medical cost reduction. However, the utilization rate has remained at about 2% since the system’s inception. A government support system for home nursing services needs to be established. Korea will enter a super-aged society in two years. The first priority in preparing for a super-aged society is providing medical services for the elderly. Government attention is necessary.

This content was produced with the assistance of AI translation services.