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

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 South 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 Co-operation 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 years; 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 (annual percent change [APC]: -15.7%; 95% 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.

Conclusion 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.