Changes in Healthcare Utilization Among Community-Dwelling Older Adults Requiring Care During the Early Phase of the COVID-19 Pandemic in Korea

Abstract

Backgrounds

Despite the extensive body of research on the COVID-19 pandemic, socially vulnerable populations have received relatively limited attention. This study investigated changes in healthcare utilization before and during the COVID-19 pandemic among a medically vulnerable group: community-dwelling older adults requiring care due to health conditions. It also explored factors associated with these changes.

Methods

This study employed a prepost design without a control group to examine changes in healthcare utilization and their associated factors among community-dwelling older adults requiring care between 2019 and 2020. Using data from the second Korean Health Panel (2019-2020), we analyzed 191 older adults. Paired t-tests were used to compare healthcare utilization before and during the pandemic, and hierarchical multiple regression analyses were conducted to identify factors associated with changes in healthcare utilization.

Results

Most participants (91.6%) were community-dwelling and were generally of low socioeconomic status. No statistically significant changes were observed in overall healthcare utilization between 2019 and 2020. However, analyses by healthcare utilization type revealed distinct factors associated with each outcome. Outpatient visits declined marginally among older adults in the second income quartile (p < 0.1) and significantly among those with cerebrovascular disease or cancer. In addition, older age, decreased in household income, medical aid beneficiary status, and cancer were significantly associated with reduced out-of-pocket expenditures. Furthermore, this study showed that the nonsignificant overall change in healthcare utilization reflected offsetting increases and decreases among individuals.

Conclusions

No statistically significant changes in healthcare utilization were observed among community-dwelling older adults requiring care due to health-related conditions during the early phase of the COVID-19 pandemic. Although overall healthcare utilization remained relatively stable, preexisting socioeconomic and clinical vulnerabilities continued to shape healthcare patterns during the pandemic. Policies aimed at protecting older adults requiring care should therefore prioritize targeted approaches that address the heterogeneous needs of socioeconomically and clinically vulnerable subgroups.