Age- and disability-based trends in potentially preventable hospitalizations: evidence from nationwide claims data in Korea.

Abstract

Objectives: Individuals with disabilities are at greater risk of hospitalization than the general population. We examined 10-year trends in potentially preventable hospitalizations (PPH) in Korea, comparing individuals with and without disabilities and assessing age-specific patterns.

Methods: Using National Health Information Database claims data (2010-2019), we established a fixed cohort of newly registered individuals with disabilities and control subjects statistically matched (1:1.5) at baseline. Annual PPH rates among patients with each condition were calculated and age- and sex-standardized according to Organization for Economic Cooperation and Development Health Care Quality Indicators definitions. Trends and annual percent changes (APCs) were analyzed by disability status and age group (non-older: 30-64; older adults: ≥65 years).

Results: Between 2010 and 2019, PPH rates declined significantly in both groups. Among individuals with disabilities, the steepest decline was observed for hypertension (APC, -15.7%; 95% confidence interval [CI], -17.7 to -13.7), whereas congestive heart failure showed the largest reduction among individuals without disabilities (APC, -7.8%; 95% CI, -10.8 to -4.7). Declines were generally greater among non-older adults aged 30-64 years, regardless of disability status. The disparity between disability and non-disability groups narrowed over the decade, primarily due to larger improvements among non-older adults. Older adults with disabilities consistently exhibited the highest PPH rates for most conditions, whereas younger individuals with disabilities had the highest rates for diabetes.

Conclusions: PPH rates declined over the decade among both individuals with and without disabilities, particularly for hypertension and among non-older adults. However, older adults with disabilities remain at elevated risk, underscoring the need for targeted strategies to improve access to community-based primary care.