Home-based medical care demand-supply gaps across 250 municipalities in Korea

Background

Korea launched its national community integrated care system in March 2026, enabling older adults to age in place with coordinated health and social services. Quantifying sub-regional demand for home-based medical services and identifying supply gaps are essential for evidence-based resource allocation under this policy.

Methods

Using publicly available data, demand was estimated via five approaches: (A) long-term care home beneficiary-based core demand, (B) expanded demand among non-beneficiary elderly aged 75 and older, (C) regression-based prediction for municipalities with limited data, (D) rehabilitation demand from stroke and fracture utilisation data, and (E) polypharmacy-based pharmacy demand. Supply indices (0–100) were constructed from 12 variables. A gap index was derived by subtracting supply from normalised demand. Ordinary least squares regression with bootstrap confidence intervals (n = 1,000) identified gap determinants. Demand projections for 2030 and 2035 applied population growth rates under two scenarios.

Results

National demand estimates were 330,576 (home visit medical care), 73,045 (nursing), 176,104 (rehabilitation), and 365,861 (pharmacy). Thirty-nine municipalities (15.6%) were high-demand/low-supply areas, concentrated in suburban metropolitan areas and urban cores of Daegu and Busan. Supply index (β = −13.2), stroke patient density (β = +11.6), and low-income household proportion (β = +6.5) were the strongest determinants (adj. R²=0.90). Demand is projected to increase 1.74-fold for medical care and 2.30-fold for nursing by 2035.

Conclusions

Substantial geographic inequity in home-based medical care supply exists across Korean municipalities. High-demand/low-supply areas, particularly those without established home care centres, require immediate policy prioritisation. Without proactive infrastructure planning, rapidly aging suburban regions face structural supply shortfalls that current expansion trajectories cannot resolve.

Key messages

• First district-level map of home-based medical care gaps across all 250 Korean municipalities, identifying 39 high-priority areas for Korea’s newly launched integrated care system.

• Demand will increase up to 2.3-fold by 2035; low-income density and stroke burden drive inequity, providing actionable targets for pre-emptive infrastructure investment.