The Effect of Having a Regular Doctor as a Primary Care Provider on Emergency Room Utilization in South Korea
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Background: Because primary care is the cornerstone of an effective health care system, many developed countrieshave striven to establish and strengthen their primary care systems. However, the primary care system in South Koreais not well established, and primary care research is still in its infancy. This study aimed to show the benefits ofregular doctors as primary care providers in South Korea by analyzing the effect of regular doctor visits on emergencyroom (ER) visits. Methods: We analyzed cross-sectional data on 11,293 adults aged 18 years and over collected from the 2013 KoreaHealth Panel Survey (beta version 1.0). We classified those participants with and without regular doctors into thetreatment and control groups, respectively, and estimated the average treatment effect (ATE) of having a regulardoctor on ER visits. We used counterfactual framework and propensity score analysis to adjust for unevenly distributedconfounding covariates between treatments and control groups. Results: The estimated conditional ATE of a regular doctor on ER visits was statistically insignificant in the generalpopulation (-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 statisticallysignificant (-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.
Abstract
Background: Because primary care is the cornerstone of an effective health care system, many developed countrieshave striven to establish and strengthen their primary care systems. However, the primary care system in South Koreais not well established, and primary care research is still in its infancy. This study aimed to show the benefits ofregular doctors as primary care providers in South Korea by analyzing the effect of regular doctor visits on emergencyroom (ER) visits. Methods: We analyzed cross-sectional data on 11,293 adults aged 18 years and over collected from the 2013 KoreaHealth Panel Survey (beta version 1.0). We classified those participants with and without regular doctors into thetreatment and control groups, respectively, and estimated the average treatment effect (ATE) of having a regulardoctor on ER visits. We used counterfactual framework and propensity score analysis to adjust for unevenly distributedconfounding covariates between treatments and control groups. Results: The estimated conditional ATE of a regular doctor on ER visits was statistically insignificant in the generalpopulation (-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 statisticallysignificant (-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.
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