장애인 건강주치의 시범사업이 의료이용에 미치는 효과 = The Effect of the Pilot Program for Primary Care Physicians for People with Disabilities on Healthcare Utilization

다국어 초록 (Multilingual Abstract)

People with disabilities face complex health problems and are at elevated risk of secondary impairments and complications due to both personal and environmental factors. To address these challenges, Korea launched the Pilot Project for Home-Based Primary Care for People with Disabilities in May 2018. However, most evaluations of the project have been confined to a single treatment period, and few studies have empirically examined how disability-tailored services affect healthcare utilization.
This study analyzed the impact of participation in the pilot project on overall, outpatient, inpatient, and emergency healthcare utilization among individuals with severe disabilities. Using customized data from the National Health Insurance Service (NHIS), a multi-period difference-in-differences (DiD) analysis was conducted. The results showed significant increases in total and outpatient healthcare utilization, while hospitalization and emergency care declined. Specifically, hospitalization rates and costs decreased by 4.329 percentage points and 45.97%, and emergency care rates and costs decreased by 2.724 percentage points and 28.03%, respectively. These findings suggest that participation in the pilot project contributed to improving health status and reducing unnecessary healthcare use among people with disabilities.
Subgroup analysis further revealed that participants in the “Main Disability & Integrated Management” group experienced significant reductions in emergency care utilization. Taken together, the findings highlight the need to strengthen disability-specific care functions and expand the pilot project into a more specialized and comprehensive system.