The effect of the expansion of the Personal Assistance Service Program on the uptake of the National Health Screening in people with severe disability

Abstract

Background Korea operates the Personal Assistance Service (PAS) program, a social service program that assists with the daily activities and coping needs of individuals with disabilities. In January 2013, the eligibility to enroll in the PAS program was expanded to include all individuals with severe disabilities. Objective As supporting individuals with disabilities is important in reducing disparities related to the uptake of health screening, this study investigated whether eligibility expansion of the PAS program was associated with increased participation in the National Health Screening Program (NHSP) among adults with severe disabilities. Methods Nationwide data from Korea that included 24 701 individuals were used. The treatment group included individuals with severe disabilities, while the control group included those with mild disabilities. The difference-in-difference approach was used to estimate differences in participation in the NHSP between the two groups before and after the intervention period. A negative binomial distribution model was applied in the analysis with adjustment for all independent variables. Results The expansion of the PAS program was directly related to an increase in NHSP uptake by people with severe disabilities (increase by 0.044 times compared to the control group following the implementation of the policy). Conclusions Expanding the eligibility for the PAS program was associated with an increase in NHSP participation among individuals with severe disabilities. These findings suggest the importance of supporting individuals with disabilities by increasing participation in health screenings to reduce potential related health disparities.