Background: The elderly are vulnerable to chronic diseases and altered lipid metabolism, leading to poor outcomes, including mortality. We investigated the association between Korean Medicine (KM) utilization, blood lipid levels, and health outcomes using the National Health Insurance Service Sample Cohort (NHIS-NSC) database. Methods: This retrospective cohort study included elderly participants who underwent health examinations (2009–2010). Participants were divided into KM and non-KM groups and matched 1:1 using propensity score matching (PSM) for age, sex, income, and comorbidities. Primary outcomes were mortality and disease diagnosis; secondary outcomes included medical spending and utilization. Results: After PSM, 13,044 subjects were analyzed. KM utilization was associated with a significantly lower risk of all-cause mortality (HR 0.93; 95% CI 0.87–1.00; p = 0.048). However, the hypolipidemia subgroup showed no significant differences in all-cause mortality and medical expenses compared to other lipid status subgroups. While the KM group showed a higher incidence of disease diagnosis (HR 1.09; 95% CI 1.04–1.14; p < 0.001), this may reflect increased healthcare engagement and proactive health-seeking behavior. Subgroup analysis revealed that statin users in the KM group had a significantly reduced mortality risk (HR 0.91; 95% CI 0.84–0.99; p = 0.022). Medical expenses and utilization were higher in the KM group. Being underweight or aged over 85 was associated with higher mortality. Conclusions: KM utilization is associated with reduced all-cause mortality after propensity score matching, particularly among statin users. Although KM users had a higher cumulative incidence of disease diagnosis, this potentially reflects increased diagnostic opportunities from prolonged survival. Hypolipidemia, underweight, and late-elderly status remain significant risk factors associated with frailty. KM may support improved survival in the elderly, warranting further prospective studies.
Hong et al. (2026) studied this question.