코로나 전·후 고령자 만성질환 외래 이용 및 진료비 변화 - Interrupted Time Series(ITS) 분석 적용 -

The purpose of this study was to examine the impact of the COVID-19 pandemic on outpatient utilization and medical expenditures among older adults with chronic diseases in Korea. Using the National Health Insurance Service sample data from 2016 to 2023, we analyzed three major chronic conditions—hypertension, diabetes, and cancer—among individuals aged 65 years and older. An Interrupted Time Series (ITS) model was employed to identify both the immediate effects of the pandemic and the long-term adaptation effects. The results showed that patients with hypertension and diabetes experienced significant reductions in both outpatient visits and medical expenditures immediately after the onset of the pandemic, and these decreases persisted over time. In contrast, cancer patients exhibited no significant changes in utilization or expenditures, suggesting continuity of care for severe conditions. In conclusion, the COVID-19 pandemic had heterogeneous effects depending on disease severity. While patients with mild chronic diseases reduced healthcare utilization due to access barriers and infection concerns, those with severe conditions maintained continuity of care. These findings underscore the need for differentiated policy responses and the expansion of telehealth and remote management services to ensure effective chronic disease care during future public health crises.