Home health care may be coming into its own

A doctor in Gangnam, southern Seoul, consults a Covid-19 patient through a video call in March, when virus cases peaked. [HANA ENT HOSPITAL]

Mr. Kim was in and out of medical clinics for the past three years to get treatment for high blood pressure, diabetes and spinal pain.

Then came the highly infections Omicron wave of the Covid-19 virus.

Kim, a 49-year-old resident of Haeundae District in Busan, was afraid to go the clinic. He requested remote treatment. Four times he consulted with doctors by telephone.

“There’s no difference from face-to-face treatment,” said Kim. “I hope I can continue to get phone treatments.”

The Covid-19 pandemic was a turning point for home health care in Korea, and demand surged for such services in the form of non-face-to-face treatment or remote care.

According to the Ministry of Health and Welfare, Covid-19 patients received a total of 18.02 million phone treatments since February 2020.

Non-Covid patients got 5.12 million phone consultations for diseases such as acute bronchitis, allergic rhinitis, high cholesterol, high blood pressure, diabetes and the common cold.

The number of users on Doctor Now, a Korean mobile application that provides remote doctor consultation and medication delivery, went up 70-fold from 80,000 in March 2021 to 5.6 million in May.

Of its 1 million users in the first quarter of 2022, more than half (52 percent) signed up for treatment for Covid-19, along with some people with illnesses they might feel embarrassed about such as hair loss and vaginitis.

“People who have dermatitis and vaginitis tend to not consult with their doctor out of embarrassment, yet they have to take medicine steadily,” said Jeon Shin-young, head of the PR team at Doctor Now. “Although they are mild diseases, it is believed that many patients [used our platform] as they require specialist treatment.”

Telemedicine through phone or video was temporarily allowed in Korea in February 2020 to battle Covid-19.

The medical community, which had opposed telemedicine services fearing their impact on its bottom line and also worried about medical accidents, accepted them due to the severity of the pandemic. Now it says the issue of remote treatment being institutionalized is “subject to negotiation.”

President Yoon Suk-yeol is in favor of its institutionalization.

Home health care is a wide range of health care services that can be received at home for an illness. It includes six different types of home visits including house calls and services from visiting nurses or disability specialists.

Yet home health care services are still relatively rare.

Last year, a total of 99.8 billion won in health insurance expenditure was spent on phone therapy and home visits, only 0.06 percent of overall medical welfare costs of 162 trillion won.

But patients who could really use home health care services are increasing rapidly due to Korea’s aging society, growing life expectancy, and a surge in single-person households.

According to a city of Seoul report on single-person households, out of 32,825 households, 15,003 people (49.2 percent) suffer from diseases while 2,713 (8.2 percent) are people with disabilities.

“A bed-ridden patient requires the help of 911 and needs to get transferred with a bed just to get their urinary catheter changed,” said Jeong Hae-jin, director of 30minclinic in Seoul’s Mapo District. “At least two family members have to keep a whole day open [to take care of a bed-ridden patient], but that would be solved if a doctor comes to the house.”

There are some 70,000 medical institutions in Korea, but only a fraction provides home visit care, such as 138 places offering house calls, four places selected for a home care pilot project for severely ill children, 38 places providing home hospice services and 640 disability specialists.

“Korea will become a super-aged society in three years, and one in five people will be elderly," said Kang Dae-hee, a professor from Seoul National University College of Medicine. “In order for patients to receive high-quality medical services at home and die comfortably, the expansion of home health care services is essential.”

Woo Bong-sik, director of the healthcare policy research institute of the Korean Medical Association, said, "Primary health care [mainly grass-roots medical clinics] should be transformed into an integrated institution [...] that plays a pivotal role in visiting nursing care."

BY SHIN SUNG-SIK, SEO JI-EUN [seo.jieun1@joongang.co.kr]