Evaluating the impact of disability support services on healthcare utilization in individuals with disabilities and hypertension in Korea

Abstract

People with disabilities often face heightened barriers to accessing healthcare services, resulting in unmet medical needs and increased prevalence of chronic conditions such as hypertension. In response, the Korean government expanded the Personal Assistance Service (PAS) program to enhance healthcare accessibility and support daily living needs for individuals with disabilities. This study aims to evaluate the impact of the PAS program expansion on healthcare utilization, specifically focusing on hospital visits for hypertension management among people with severe disabilities. We used sample cohort data from the National Health Insurance System. The difference-in-differences approach was used to estimate differences in hospital utilization between the treatment and control groups before and after the intervention period. The expansion of PAS program was associated with an increase in hypertension total visits increase of 0.128. Specifically, the number of outpatient visits increased by 0.132. The increase in hospital visits was more pronounced in unclassified disability types. Seasonal variations and higher Charlson Comorbidity Index (CCI) scores were positively associated with increased hospital visits. The results reveal that expanding enrollment in programs for people with disabilities was linked to an increase in outpatient visits among people with severe disabilities. This study is noteworthy because the expansion of services could potentially help bridge health disparities.