Who are the most vulnerable populations for primary care? Avoidable hospitalizations across individuals with different types of disabilities in South Korea

Abstract

BackgroundIndividuals with disabilities have limited access to primary care, the quality of care must be examined. ObjectiveTo examine avoidable hospitalizations among individuals with disabilities and determine the most vulnerable populations across types of disabilities. MethodsUsing the Korean National Health Insurance Claims Database, we compared hypertension- and diabetes-related avoidable hospitalizations (HRAH and DRAH, respectively) across disability status and disability type based on age-sex standardized rates from 2011 to 2020 and logistic regression. ResultsThe gap between those with and without disabilities in age-sex standardized HRAH and DRAH increased over 10 years. Odds ratios for HRAH were higher for those with disabilities, with individuals with mental disabilities having the highest odds ratio, followed by those with intellectual/developmental disabilities, then those with physical disabilities; for DRAH, the three highest odds ratios belonged to individuals with mental, intellectual/developmental, and visual disabilities. Among those with disabilities, HRAH was higher for those with mental, intellectual/developmental, and severe physical disabilities, whereas DRAH was higher for those with mental, severe visual, and intellectual/developmental disabilities compared to those with mild physical disabilities. ConclusionThis study reveals high avoidable hospitalization rates among individuals with disabilities and calls for policies supporting quality primary care and comprehensively addressing disparities.