The Clinical Necessity and Policy Roadmaps for Neurologist-guided Home Medical Services in a Super-aged Era

The ongoing transition of South Korea into a superaged society has resulted in a marked increase in the prevalence of complex neurological disorders among the homebound elderly. Traditional hospital-centric models often fail to reach these individuals, resulting in neurological desertification. This review article highlights the indispensable role of neurologists in home-based medical care (HBMC). Neurologists provide specialized diagnostic precision that allows specific neurological pathologies to be differentiated from the vague category of frailty. This article analyzes current pilot programs, specifically the Dementia Management Attending Physician Pilot Project and the 2026 Integrated Regional Care Act. By utilizing ecological validity in the patient’s home, neurologists can optimize medication for polypharmacy and allow multidisciplinary teams to optimally manage advanced neurodegenerative diseases such as Parkinson’s disease and amyotrophic lateral sclerosis. We propose a strategic roadmap involving specialized fee structures, digital health integration, and educational reforms to establish a sustainable neurological HBMC ecosystem that ensures aging in place with dignity.