Technology-Dependent Children Living at Home in Korea: A Population-Based Analysis Using NHIS Claims Data.

BACKGROUND

Advances in medical technology have improved the survival of critically ill children, resulting in a growing population of technology-dependent children (TDC). Given their substantial healthcare needs and often complex care, understanding the prevalence and healthcare utilization of TDC is crucial for informed decision-making for healthcare professionals and policymakers. This study aimed to investigate the prevalence, incidence, and healthcare utilization of TDC in Republic of Korea (South Korea).

METHODS

This retrospective, population-level study analyzed the National Insurance Service claims data in Korea from 2018 to 2019. Children and adolescents aged 0-18 years living at home with technology dependence for respiratory (invasive/non-invasive ventilation, tracheostomy, or oxygen therapy) or nutritional support (nasoenteric or gastrostomy tube feeding) were included. We estimated 2-year prevalence, 1-year incidence, and healthcare utilization, including subgroup comparisons by complex chronic condition (CCC) status.

RESULTS

In total, 3,306 children were identified as TDC: 1,889 required respiratory support (21.5 per 100,000), and 2,036 required tube feeding (23.2 per 100,000). The mean age was 4.4 ± 5.4 years for respiratory-dependent and 6.2 ± 5.8 years for nutritional-dependent children. Most of the children had ≥ 1 CCC. Compared with non-CCC counterparts, children with CCC had longer hospital stays (125 vs. 35.8 days), more intensive care unit days (74.6 vs. 35.8), and higher annual healthcare costs per patient ($49,870 vs. $10,430). The overall 1-year mortality was 17.0%, with higher rates among patients with CCC.

CONCLUSION

TDC represent a relatively small but medically complex population with high healthcare needs and utilization. These findings highlight the importance of coordinated and multidisciplinary home-based care. Further studies are warranted to guide interventions and policies that support improved outcomes for TDC and their families.