Health ministry finds wide gaps in regional care supply

South Korea's health ministry said Tuesday that a first-of-its-kind nationwide survey of integrated community care found large regional gaps in the supply of services for older adults and disabled people, with visiting medical care and home-based health services the most unevenly distributed.

The Ministry of Health and Welfare released the results of the Regional Community Integrated Care Survey, which analyzed care demand and the supply of 16 linked services across all 229 cities, counties and districts. The survey is the first conducted under the law on integrated support for regional care, which requires it every five years.

The ministry estimated a potential care group of 3.208 million older adults, or 28.5 percent of the elderly population, and a core group of 983,000, or 8.7 percent. Among disabled people under 65, the potential group was 608,000, or 52.8 percent of registered disabled people in that age range, with a core group of 150,000. Those groups are policy analysis categories rather than a list of actual beneficiaries; whether an individual receives integrated care depends on health status, daily functioning, housing and family circumstances.

Supply meeting estimated demand varied widely by service. Visiting care for older adults reached 96.9 percent and activities support for disabled people 89.7 percent, while visiting health management stood at 75.6 percent. At the other end, short-term respite care was 1.5 percent, the emergency care support program 7.0 percent, visiting doctors for disabled people 16.9 percent and home-based medical centers 17.7 percent.

The ministry said the fulfillment rates are a gauge of where supply should be expanded at this early stage of the program, not a measure of current service failure, and should be read as priorities for concentrated funding. It noted that the emergency care program's low rate partly reflects the absence of Seoul, Gyeonggi Province and other regions from the program.

Regionally, visiting treatment reached 25.5 percent of estimated demand in general areas but 10.7 percent in depopulating areas, while home-based medical centers stood at 20.6 percent and 8.3 percent. The average road distance to a provider of visiting doctors for disabled people was 20.8 kilometers in depopulating areas, nearly double the 10.9 kilometers elsewhere.

Across the 229 districts and 16 services, 59 districts were classified as high-demand and low-supply, and 40 of them, or 67.8 percent, were depopulating areas. Another 119 were low-demand and low-supply, 38 were high-demand and high-supply, and 13 were low-demand and high-supply.

The country has 162,482 health, medical, nursing and care institutions and 1,651,219 related workers, the survey found, with long-term care staff accounting for the largest share at 825,515.

In the first months of the program, 93,136 people applied for integrated care as of Aug. 31, an average of about 870 a day, of whom 91,952 were older adults and 1,184 were disabled people under 65. A total of 78,677 people received linked services, averaging 3.5 services each.

"This survey is meaningful in that it analyzed care demand and service supply conditions in every city, county and district nationwide on the same standards and specifically identified which service foundations need to be supplemented in each region," Health Minister Chung Eun-kyung said. "We will actively use the results in the basic plan and regional plans, and expand the necessary services step by step according to regional conditions so that people can receive the medical, nursing and care services they need without interruption wherever they live."

Local governments will use the findings to draw up regional plans by November for cities, counties and districts and by December for provinces and metropolitan cities, with about 110 advisers recruited to provide counseling from October. The ministry aims to expand home-based medical centers to 650 by 2030 from 463 as of late September, and to raise the number of dedicated staff in community rehabilitation programs at public health centers to 385 next year from 257.