"Integrated community care," which allows elderly residents to spend their remaining years receiving medical, nursing and caregiving services in the communities where they have lived, takes effect nationwide starting May 27. This marks the first step in a paradigm shift in eldercare — enabling seniors who struggle with daily activities to receive customized services such as home-visit medical treatment, nursing, rehabilitation and housekeeping support at home rather than in hospitals or nursing facilities, while easing the burden on their families. South Korea entered a super-aged society in 2024, with those aged 65 and older accounting for 20% of the population, and by 2050, one in five citizens is projected to be aged 80 or older. Reorganizing the increasingly burdensome care system around local communities presents an opportunity to dramatically improve the quality of life for citizens. The government plans to phase in the program starting this year, aiming to establish a unified community care system accessible to "anyone who needs care" by 2030.
The challenge lies in securing the workforce and budget to meet surging care demand. Local governments are critically short of specialized personnel — such as visiting physicians — relative to their elderly populations, while caregiving workers including certified care assistants are demanding wage increases and calling on the government to negotiate. Moreover, of the 91.4 billion won allocated for integrated care this year, only 62 billion won is available as operational funding that local governments can actually spend. It is questionable whether a community-based care system can function on an average budget of just 270 million won per city, county or district. Disparities in care service levels between regions are also a concern. The infrastructure gap between the Seoul metropolitan area and the rest of the country is already significant, and 98 of the nation's 229 basic local governments only began pilot programs in September last year, indicating inadequate preparation. There is a strong likelihood that service quality will become polarized depending on where people live.
Surveys show that eight out of 10 Korean adults aged 40 and older wish to receive care in their own homes or neighborhoods in old age. An old age spent being shuffled among hospitals, rehabilitation centers and nursing facilities is nothing short of suffering. This is precisely why so many people have no choice but to pin their hopes on integrated community care, even though its launch is akin to setting off before the doors are fully open. As an immediate priority, the government needs to closely monitor regional gaps and promptly devise measures to prevent imbalances in local care delivery. If integrated community care is to serve as a safety net that upholds citizens' "dignified old age," the central government, local governments, and medical and health institutions must build an organic cooperative framework and establish a system that delivers quality care to all citizens.