Impact of a Social Media Derived Digital Self Management Platform on Population Level Irritable Bowel Syndrome Emergency Utilization: A Controlled Interrupted Time Series Analysis Using South Korean National Health Insurance Data

BackgroundIrritable bowel syndrome (IBS) contributes disproportionately to gastrointestinal-related emergency department (ED) utilization in South Korea, yet evidence on population-level interventions informed by patient-generated digital discourse remains limited. Recent social media analyses have identified dominant thematic concerns among IBS patients, including dietary triggers, symptom management, psychosocial burden, and information-seeking, suggesting actionable targets for digital self-management tools. ObjectiveTo evaluate the population-level impact of the Jang Geongang (, "Gut Health") digital self-management platform, whose content architecture was informed by topic modeling of IBS-related social media discourse, on IBS-attributed ED visits and unplanned hospitalizations, using a controlled interrupted time series (CITS) design. MethodsWe analyzed monthly aggregate claims data from South Koreas National Health Insurance Service (NHIS) spanning January 2018 to December 2024 (84 monthly observations). The Jang Geongang platform was launched in four pilot metropolitan areas (Seoul, Incheon, Daejeon, Gwangju) in July 2021, with eight non-pilot metropolitan areas serving as concurrent controls. Segmented regression with Newey-West heteroskedasticity and autocorrelation consistent (HAC) standard errors was used to estimate changes in level and trend of IBS-attributed ED visits per 100,000 insured population. Sensitivity analyses included autoregressive integrated moving average (ARIMA) transfer function models, varying pre-intervention windows, and leave-one-out control exclusion. ResultsThe CITS model estimated an immediate level change of -3.42 IBS-attributed ED visits per 100,000 (95% CI: -5.18 to -1.66, p < 0.001) following platform launch, and a change in monthly trend of -0.19 visits per 100,000 per month (95% CI: -0.31 to -0.07, p = 0.003), compared to control areas. By December 2024, the cumulative estimated reduction was 10.5 ED visits per 100,000 (23.8% relative reduction). Effects were concentrated in younger adults (19-39 years; level change: -5.14, p < 0.001) and IBS-D subtype visits (level change: -4.87, p < 0.001). ARIMA transfer function models corroborated these findings (immediate impact: -3.28, p = 0.001). Unplanned hospitalizations showed a smaller but significant reduction (level change: -0.84 per 100,000, p = 0.018). ConclusionsA digital self-management platform designed using social media derived IBS patient discourse insights was associated with sustained population-level reductions in IBS-attributed emergency utilization. Controlled interrupted time series analysis provides robust evidence for the public health impact of translating social media analytics into scalable digital health interventions.