The 2020 disease burden and economic implications of digestive diseases in Korea: a nation-wide comprehensive study

Background/Aims: Digestive diseases are highly prevalent and contribute substantially to healthcare utilization and costs. However, national-level data on digestive diseases burden in Korea are limited. This study aimed to estimate the healthcare burden of digestive diseases in Korea via a national database analysis.Methods: We analyzed the 2020 National Patient Sample data from the Health Insurance Review and Assessment Service, covering the entire Korean population. Digestive diseases were grouped into seven categories. Medical utilization and expenditures were assessed using two criteria: the principal estimate (primary diagnosis only) and the extended estimate (primary plus first-listed secondary diagnosis).Results: Approximately 18.5 million individuals (39.2% of all patients) received care for digestive diseases, according to the principal estimate, and 30.1 million (63.8%) received care, according to the extended estimate. Corresponding medical exdigespenditures were $8.5 billion (11.6% of total national healthcare costs) based on the principal estimate and $14.4 billion (19.6%) based on the extended estimate. Although only 7.4% of patients were hospitalized, they accounted for 51.4% of the total expenditure for digestive diseases. Colorectal cancer incurred the highest inpatient costs. Gastroesophageal reflux disease was the most common and expensive diagnosis in outpatients. Intestinal infectious diseases were the leading causes of hospitalization and emergency department visits; foreign body ingestion was a key driver in pediatric emergency cases.Conclusions: Digestive diseases impose significant clinical and economic burdens in Korea. Their frequent occurrence as primary and comorbid diseases highlights the need for comprehensive healthcare strategies and informed policy planning.