Text box 1. Contributions to the literature
• Evidence on the economic and clinical burden of polypharmacy among older adults in South Korea remains limited.
• This study shows that polypharmacy is linked to increased hospitalization, mortality, and healthcare costs, especially in those aged 65–79 and living alone.
• The findings support the development of integrated care models, including medication reviews and social support services, to reduce risks and spending.
• Results provide actionable insights for healthcare policymakers aiming to improve care coordination and reduce unnecessary medication use among the elderly.