Referral Pathways and Outcome-Information Continuity in Home-Based Primary Care Before the Republic of Korea’s National Integrated-Care Reform: A Retrospective Descriptive Study
Dae Hyun Kim, Joo Hyung Kim, Sunjoo BooIntroduction:
Republic of Korea’s Integrated Care Act aims to coordinate home-visit medical, nursing, and social care for older people. However, whether the Act’s administrative pathway serves as the main entry route into home-based primary care (HBPC), and whether outcome information returns to the treating clinic, has not been well documented. We described referral pathways and outcome-information continuity at a single HBPC clinic before nationwide implementation of the reform.
Methods:
This was a single-center retrospective descriptive cohort study using de-identified secondary clinical and administrative records from 190 patients referred to a HBPC clinic in Seongnam, Republic of Korea, in 2025. Referral sources were classified as either administrative or frontline pathways. Outcome-information continuity was measured broadly (traceable outcome) and strictly (return of cross-boundary event information).
Results:
Of 190 patients, 178 (93.7%) were referred through the frontline channel and 12 (6.3%) through the administrative channel. Administrative pathway patients more often lived alone, received medical aid, and were functionally dependent. Outcomes were traceable for 46 patients (24.2%), of whom 29 had cross-boundary information returned to the clinic; 144 (75.8%) had none.
Conclusion:
Entry into HBPC was overwhelmingly frontline-driven, rather than routed through the administrative pathway the Act assumes, and outcome information returned for only a minority of patients, indicating that the linkage between HBPC and the wider care system was largely 1-directional. Two-way, information-enabled coordination is a prerequisite if integrated care is to move beyond referral linkage toward actual continuity of care.