Service Demand for and Awareness of a Primary Healthcare Pilot Project for People With Disabilities

Abstract

Background This study investigated the demand for and awareness of a primary healthcare pilot project for people with disabilities; it also sought to identify relevant determinants for demand and awareness using Andersen’s behavioral model of health service use. Methods This study is a secondary analysis of data from the population-based survey conducted in Gyeonggi Regional Health & Medical Center for People with Disabilities. The data was designed with quota random sampling based on the population with disabilities in each district (city [si] and county [gun]) across the Gyeonggi province (do) to evaluate the health and healthcare accessibility of the disabled people living in the Gyeonggi province. The data was collected through the mobile-based survey of 1,140 people with disabilities living in Gyeonggi-do between March 2021 and June 2021. Results Awareness of the service (12.1%) was remarkably low, while the demand (80.5%) was high. The gap between respondents who needed the service but were unaware of it differed according to age, education, activities of daily living, health information sources, chronic disease, depression, subjective health status, and unmet healthcare needs. Chronic disease (odds ratio [OR], 1.86; P = 0.001) and an unmet need for medical care (OR, 2.30; P = 0.002) had significant influences on demand for the service. Furthermore, living alone (OR, 0.42; P = 0.023), medical aid program beneficiary status (OR, 2.10; P = 0.020), access to health information from health service centers (OR, 4.00; P = 0.002), chronic disease (OR, 1.68; P = 0.043), severity of disability (OR, 1.78; P = 0.025), and subjective health status (OR, 4.51; P < 0.001) significantly affected awareness of the program. Conclusion Chronic disease and an unmet need for medical care were key determinants of service demand, while the severity of disability was not. Thus, there is a need to review the initiative that defines service beneficiaries as people with severe disabilities. Policy makers should consider advertising programs to improve service awareness among people with disabilities.

Disability and Emergency Department Visits: A Path Analysis of the Mediating Effects of Unmet Healthcare Needs and Chronic Diseases

“…A study investigating the demand for this project reported that having chronic diseases and an unmet need for medical care was significantly related to a higher demand for the project among people with disabilities. 39 When designing a program for people with disabilities, considering the need for home-visiting services can reduce the barriers to care and unnecessary ED visits, which can be an economic burden to the healthcare system. 33 Future studies need to explore the reasons and causes of ED visits among people with disabilities by their different types of disabilities.…”

Characteristics of Homebound and Patients with Disability Who Use Home-Based Primary Care in Korea: A Retrospective Study for 2018–2022

“…The first HBPC service, launched in May 2018, was a pilot project for the primary care of people with disabilities. Physicians and nurses from the primary clinic completed 2 days of training and visited severely disabled people registered in the National Pension Service to provide medical services [ 18 ].…”

“…More than 90% of patients were dependent in daily living (completely dependent, 42.7%; partially dependent, 49.7%). The overall K-ADL score (median, IQR) was 14 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The most common medical conditions of homebound patients were dementia (27.1%) and difficulty with physical mobility (21.9%).…”

“…5 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) for nurses. For homebound patients, it was 1 (1-2) for physicians and 4 (1-12.5) for nurses.…”

“…After hospital-based homecare nursing was introduced in 2001, HBPC with physician visits was first introduced in 2018 [ 17 ]. The HBPC service for the disabled began in 2018, and the more general service for homebound patients began in 2019 [ 18 ]. In both programs, a primary physician visits homebound patients living in the community to provide medical services.…”