Objective: The purpose of the study was to identify the differences of medical costs and healthcare use between the elderly with disabilities and without disabilities.
Methods: We selected the elderly with disabilities (disabilities; n=18,686) among those aged over 65(n=109,785) in 2010. The elderly without disabilities (non-disabilities) was matched to the elderly with disabilities according to age group, gender, region, insurance type, insurance premium, the number of chronic diseases, and CCI scores using the propensity score matching (PSM). Chi-square test, t-test, ANOVA analyses were used to calculate the healthcare use costs. Data sources were the Korean National Health Insurance Research Database in 2010.
Results: As a result of 1:1 matching of disabilities and non-disabilities, 37,372 elderly people (18,686 disabilities and 18,686 non-disabilities) were selected.
Before PSM, the mean medical expenditure for the disability group was approximately 2.1 times higher(181,996±984,780) than the non-disability group (87,660±577,550; p<0.001). After PSM, the mean medical expenditure for disabilities was approximately 1.9 times higher (181,996±984,780) than non-disabilities (96,613 ±610,028; p<0.001).
Before PSM, the average length of hospital stay and hospital visits for the disabled was approximately 1.5 times longer (2.25±5.59) than the non-disabled (1.54±3.49; p<0.001). After PSM, the average length of hospital stay and hospital visits for the elderly with disabilities was approximately 1.4 times longer(2.25±5.59) than those without disabilities (1.60±3.61; p<0.001).
By disability type, heart disease accounted for the highest level of medical expenditure (490,709 ±1,043,913). The average length of hospital stay and hospital visits was the highest for mental disabilities (5.96±10.91).
Conclusion: With the Korean society increasingly aging, the medical costs for the elderly have increased as well. In particular, the elderly with disabilities spend more money to receive medical and healthcare services compared to the elderly without disabilities. Therefore, effective health management programs and treatments are needed to reduce medical costs for the elderly with disabilities.
This study was funded by Korea National Rehabilitation Research Institute grant(code #15-S-02) and approved by the Institutional Review Board of the Korea National Rehabilitation Center(NRC-2015-02-010).
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