J Korean Geriatr Soc.  1997 Oct;1(1):55-64.

Health Service Utilization Patterns Among The Chronically Disabled Aged in Korea

• Cho KH

Abstract

OBJECTIVE
Author hypothesized that the presence of a chronic disease burden would change patients' use of health services.
METHODS
This research used 4,020,172 medical payment requests(corrected for duplication) and a subset of 1,342,845 payment requests for chronic disease to analyze the pattern of health services utilization among the aged in Korea in 1991. Chronic disease was defined by ICD-9 codes as used in the US Health Services Interview Survey. Author traced the utilization of primary, secondary and tertiary facilities by diagnoses of patients. Thereafter author compared the utilization of health service by age groups, sex, and patterns of care in the chronically disabled.
RESULTS
Our data showed that younger seniors are more likely to self refer to tertiary health care. Men are more likely to use tertiary care. On the other hand, women tend to use more primary care. Inpatient tertiary level service is strongly preferred over secondary or primary health services. Patients with chronically disabled had increased use of tertiary care facilities and more self-referrals for care. Secondary health service appeared to be under used.
CONCLUSIONS
Comparing the results of utilization pathway of elder clients showed chronically disabled patients overutilize the health service and pursuit the multi-pathways. Especially, overused tertiary care by the elderly may play a part in overstraining of tertiary medical resources in Korea. Thus, there is a strong necessity to introduce long term care systems for the chronically disabled elderly in Korea.

Keyword

Chronic disease; Aged; Utilization

MeSH Terms

Aged
Chronic Disease
Delivery of Health Care
Diagnosis
Female
Hand
Health Services*
Humans
Inpatients
International Classification of Diseases
Korea*
Long-Term Care
Male
Primary Health Care
Tertiary Healthcare