Korean J Fam Med.  2017 Nov;38(6):322-326. 10.4082/kjfm.2017.38.6.322.

The Effect of Having a Regular Doctor as a Primary Care Provider on Emergency Room Utilization in South Korea

• Lee SY
• Lim HS

• KMID: 2395323
• DOI: http://doi.org/10.4082/kjfm.2017.38.6.322

Abstract

BACKGROUND
Because primary care is the cornerstone of an effective health care system, many developed countries have striven to establish and strengthen their primary care systems. However, the primary care system in South Korea is not well established, and primary care research is still in its infancy. This study aimed to show the benefits of regular doctors as primary care providers in South Korea by analyzing the effect of regular doctor visits on emergency room (ER) visits.
METHODS
We analyzed cross-sectional data on 11,293 adults aged 18 years and over collected from the 2013 Korea Health Panel Survey (beta version 1.0). We classified those participants with and without regular doctors into the treatment and control groups, respectively, and estimated the average treatment effect (ATE) of having a regular doctor on ER visits. We used counterfactual framework and propensity score analysis to adjust for unevenly distributed confounding covariates between treatments and control groups.
RESULTS
The estimated conditional ATE of a regular doctor on ER visits was statistically insignificant in the general population (-0.4%; 95% confidence interval [CI], -2.0 to 1.2) and in the subgroup of patients with hypertension (-1.8%; 95% CI, -4.5 to 0.9). However, in patients with diabetes mellitus (DM), the estimated ATE was statistically significant (-5.0; 95% CI, -9.2 to -0.7).
CONCLUSION
In the total study population, having a regular doctor did not result in a significant difference in ER visits. However, there was a decrease in ER visits in patients with DM in South Korea.

Keyword

Primary Health Care; Emergency Departments; Treatment Outcome; South Korea; Propensity Score

MeSH Terms

Adult
Delivery of Health Care
Developed Countries
Diabetes Mellitus
Emergencies*
Emergency Service, Hospital*
Humans
Hypertension
Korea*
Primary Health Care*
Propensity Score
Treatment Outcome