의료기관 외 물리치료 서비스 제공 시 국민건강보험 재정 및 편익성에 미치는 영향 분석 = Impact of Providing Non-Hospital Physical Therapy Services on National Health Insurance Expenditure and Public Benefit

다국어 초록 (Multilingual Abstract)

Purpose: This study examined the impact of providing physical therapy services outside hospital settings on the financial burden of the Korean National Health Insurance (NHI) system as well as on patient accessibility and satisfaction. In particular, we evaluated whether community-based and home-based physical therapy models could reduce unnecessary physician consultations and enhance public convenience.

Methods: A cross-sectional survey was conducted with 266 participants (197 patients and 69 caregivers) receiving physical therapy at hospitals or clinics nationwide. The questionnaire included demographic characteristics, patterns of physical therapy utilization, frequency of physician consultations, travel time, satisfaction with care, and perceptions of community-based services. To estimate potential reductions in NHI expenditure, we modeled a scenario in which all physician consultations related to physical therapy were standardized to twice per month, applying the 2024 outpatient revisit fee of 12,590 KRW. Descriptive statistics and multiple regression analyses were performed.

Results: Most respondents regularly received physical therapy at hospital-based facilities, and more than 80% reported being satisfied with the current services. However, 83.0% indicated that accessibility would improve if physical therapy were available in community centers or closer to home, and 87.6% supported NHI coverage for community-based physical therapy. Factor analysis identified perceived appropriateness of physical therapy as the strongest predictor of overall satisfaction (β = .318, p < .001), followed by service convenience (β = .144, p = .013). In the modeled scenario, standardizing physician consultations to twice monthly for patients currently visiting daily or weekly resulted in an estimated annual NHI expenditure reduction of approximately 287 million KRW.

Conclusion: These findings suggest that implementing community-based and home-based physical therapy within the Korean health-care system may improve accessibility and satisfaction while reducing avoidable physician consultations and associated NHI costs. Non-hospital physical therapy services represent a potentially efficient and patient-centered alternative to conventional hospital-based models.