Long-term care hospitals as end-of-life care settings in South Korea: A nationwide analysis of utilization patterns and clinical trajectories.
Most Korean long-term care hospital patients who die, die during that admission.
Long-term care hospitals as end-of-life care settings in South Korea: A nationwide analysis of utilization patterns and clinical trajectories.
This study aimed to investigate the utilization patterns and end-of-life trajectories of older adults in Korean long-term care hospitals (long-term care hospitals) using nationwide population-based data.
This retrospective observational study analyzed National Health Insurance Service claims data (2014-2023).
68.5% of decedents died while still admitted to the long-term care hospital.
Patients were newly admitted to long-term care hospitals in their early 80s (median age 81 years, IQR 75-86) and were predominantly female (62.1%).
In addition, Medical Aid beneficiaries (13.7%) and individuals with registered disabilities (28.0%) were overrepresented, indicating high sociodemographic vulnerability.
Decedents spent a median of 79 days (IQR 22-299) as long-term care hospitals inpatients.
While 30.1% stayed for <30 days, 22.2% remained hospitalized for ≥ 360 days, indicating substantial variation in length of stay.
Long-term care hospitals in Korea have played an increasingly important role as a setting for end-of-life care, managing a distinct trajectory from chronic frailty to acute deterioration.
Given that these institutions are functioning as end-of-life care settings, policy reforms should strengthen palliative care integration, advance care planning, workforce training, and end-of-life care capacity within long-term care hospitals.