Ma Sujin, Jeon Huiwon, Noh Yoohun, Noh Jin-Won
Department of Health Administration, Graduate School of Yonsei University, Wonju 26493, Republic of Korea.
Department of Health and Medical Information, Ansan University, Ansan 15328, Republic of Korea.
Healthcare (Basel). 2025 Aug 21;13(16):2076. doi: 10.3390/healthcare13162076.
With rapid population aging, concerns about cognitive health-especially mild cognitive impairment (MCI), a prodromal stage of dementia-are growing. Although MCI prevalence is rising, limited empirical evidence exists on changes in healthcare expenditures associated with its diagnosis. This study aimed to assess shifts in medical spending before and after MCI diagnosis and to identify factors influencing healthcare costs among Korean adults. We used data from the National Health Insurance Service-National Health Information Database (NHIS-NHID) from 2020 to 2022. This study analyzed 4162 Korean adults aged ≤84 who were newly diagnosed with MCI in 2021. Annual healthcare expenditures were tracked from 2020 to 2022. Generalized estimating equations (GEEs) were employed to examine changes over time, adjusting for sociodemographic characteristics, comorbidities, healthcare utilization, and long-term care insurance (LTCI) enrollment. The average annual healthcare expenditure increased from 74,767 KRW before diagnosis to 87,902 KRW after diagnosis, reflecting a 12.51% rise. Regression analysis showed a significant decrease in costs in the year prior to diagnosis (β = -0.117, < 0.01) and an increase in the year following diagnosis (β = 0.061, < 0.01). Higher expenditures were associated with greater outpatient visits (β = 0.385, < 0.01), longer hospital stays (β = 0.039, < 0.01), LTCI enrollment (non-graded: β = 0.035, = 0.02; graded: β = 0.027, = 0.04) and higher comorbidity levels (CCI = 2: β = 0.088, < 0.01, CCI ≥ 3: β = 0.192, < 0.01). Conversely, older age (β = -0.003, = 0.02) and female sex (β = -0.093, < 0.01) were associated with lower costs. Sex-stratified analyses revealed consistent cost trends but different predictors for male and female patients. Healthcare expenditures rise significantly after MCI diagnosis. Early identification and interventions tailored to patient characteristics-such as age, sex, and comorbidity status-may help manage future costs and support equitable care for older adults.
随着人口老龄化的迅速加剧，人们对认知健康的担忧日益增加，尤其是对轻度认知障碍（MCI），即痴呆症的前驱阶段。尽管MCI的患病率在上升，但关于其诊断相关医疗保健支出变化的实证证据有限。本研究旨在评估MCI诊断前后医疗支出的变化，并确定影响韩国成年人医疗保健成本的因素。我们使用了2020年至2022年韩国国民健康保险服务-国民健康信息数据库（NHIS-NHID）的数据。本研究分析了2021年新诊断为MCI的4162名年龄≤84岁的韩国成年人。跟踪了2020年至2022年的年度医疗保健支出。采用广义估计方程（GEEs）来检验随时间的变化，并对社会人口学特征、合并症、医疗保健利用情况和长期护理保险（LTCI）参保情况进行了调整。平均年度医疗保健支出从诊断前的74,767韩元增加到诊断后的87,902韩元，增长了12.51%。回归分析显示，诊断前一年的成本显著下降（β = -0.117，P < 0.01），诊断后一年成本增加（β = 0.061，P < 0.01）。较高的支出与更多的门诊就诊次数（β = 0.385，P < 0.01）、更长的住院时间（β = 0.039，P < 0.01）、LTCI参保（未分级：β = 0.035，P = 0.02；分级：β = 0.027，P = 0.04）以及更高的合并症水平（Charlson合并症指数（CCI）= 2：β = 0.088，P < 0.01，CCI≥3：β = 0.192，P < 0.01）相关。相反，年龄较大（β = -0.003，P = 0.02）和女性（β = -0.093，P < 0.01）与较低的成本相关。按性别分层分析显示成本趋势一致，但男性和女性患者的预测因素不同。MCI诊断后医疗保健支出显著增加。根据患者特征（如年龄、性别和合并症状况）进行早期识别和干预，可能有助于控制未来成本，并为老年人提供公平的护理。
