This file photo taken on May 3, 2024, shows a patient at a hospital in Seoul. (Image courtesy of Yonhap)
SEOUL, Feb. 18 (Korea Bizwire) — A stark disconnect exists between how elderly South Koreans hope to spend their final days and where they actually die, according to a comprehensive study released on February 17 by the National Health Insurance Service Research Institute.
The analysis found that while 67.5% of elderly long-term care recipients wish to die at home, about 73% passed away in medical facilities in 2023. The study examined healthcare and long-term care benefits used by 169,943 deceased seniors in their final year of life.
Among medical facilities, nursing hospitals accounted for 36% of deaths, while general hospitals represented 22.4%. Only 14.7% of seniors died at home, and 12.4% passed away in care facilities.
The study revealed extensive use of life-sustaining treatments in the final month of life, with nearly 60% of seniors receiving such care. Blood pressure medications were the most common intervention at 48.7%, followed by artificial nutrition at 38%, blood transfusions at 15.1%, and both artificial respiration and cardiopulmonary resuscitation at 9.6% each. Nursing hospitals administered 45% of blood pressure medications and 55.6% of artificial nutrition cases.
Healthcare costs escalated significantly as death approached, with 42.4% of the year’s total expenses occurring in the final three months. The average monthly cost peaked at 4.08 million won in the last month before death. Throughout their final year, individuals averaged 25 million won in health insurance benefits and 15 million won in long-term care benefits.
Only 13.1% of elderly care recipients had documented end-of-life care plans, with more than half of these decisions made in their final month. Just 7.6% of all deceased seniors had their end-of-life care plans implemented. The likelihood of having and implementing such plans decreased with age.
Based on these findings, researchers concluded that most elderly individuals received end-of-life care that diverged from their stated preferences. The institute recommended several policy changes, including better systems for documenting end-of-life care preferences, establishing dedicated end-of-life care within the long-term care insurance system, and addressing gaps in medical coverage for long-term care recipients near death.
M. H. Lee (mhlee@koreabizwire.com)
