HC3 - Comparison of Medical Costs, Health Care Utilization, and Health Outcomes Between the Elderly with and Without Disabilities in Korea

Abstract

This study aims to identify the differences of medical costs and healthcare use in the elderly with and without disabilities and investigate the relationship between the health outcomes (hospitalization, emergency department visits, death) and disabilities in older adults in Korea. This study used data from the nationwide databases: Korea National Health Insurance Corporation, the National Disability Registry of Ministry of Health and Welfare. We selected the elderly with disabilities (disabilities; n=975,018) among adults aged 65 years and over (n=5,980,060) in 2012. The elderly without disabilities (non-disabilities) was matched to the elderly with disabilities according to sex and age, using the 1:2 matching. T test and ANOVA were used to estimate medical costs and healthcare use according to disability and multivariable logistic regression analysis was used to identify the relationship between the health outcomes and disabilities. As a result of 1:2 matching of disabilities and non-disabilities, 2,925,054 elderly people (975,018 disabilities and 1,950,036 non-disabilities) were selected. The mean medical expenditure for the disability group was approximately 1.9 times higher($3,247±$6,681) than the non-disability group ($1,681±$3,587; p<0. 0001). The average length of hospital stay for the disabled was approximately 1.4 times longer (67±79) than the non-disabled (48±55; p<0. 0001, unit: days). The disability group was associated with higher risk of hospitalization (OR 1.09, 95% CI: 1.08-1.11), emergency department visits (OR 1.26, 95% CI: 1.22-1.30) and death (OR 1.18, 95% CI: 1.11-1.25) than the non-disability group. By disability type, renal disability accounted for the highest level of the mean medical expenditure ($24,777±$10,570) and the average length of hospital stay (176.49±85.55, unit: days). With the Korean society increasingly aging, the elderly with disabilities will pay more money to receive healthcare services than the elderly without disabilities. Thus, the findings supported needs of effective health management programs and treatments for the elderly with disabilities to reduce medical expenditures.