The Longitudinal Study on the Factors of Catastrophic Health Expenditure Among Disabled Elderly Households

장애노인 가구의 과부담 보건의료비 결정요인에 관한 종단적 연구

This study examines the scale of occurrence of Catastrophic Health Expenditure, and identifies the factors influencing Catastrophic Health Expenditure among disabled elderly households. Catastrophic Health Expenditure is defined by when the households' health care spending out of ability to pay exceeds 10%, 20%, 30%, and 40%. This study used the 2008, 2009, and 2010 surveys of the Panel Survey of Employment for the Disabled(PSED) to explore how gender, age, spouse, the level of education, the degree of disability, the type of disability, disability duration, subjective health status, chronic disease, the number of household members, the proportion of disabled households, the proportion of working households, the proportion of aged households, the type of poverty, household income, net asset, determine Catastrophic Health Expenditure among disabled elderly households. The study examines the frequency of Catastrophic Health Expenditure with 726 households, and conducted the panel logit model. The empirical results show that Catastrophic Health Expenditures are significantly related to age, spouse, the type of disability, subjective health status, chronic disease, the number of households, the proportion of disabled households, the proportion of aged households, the type of poverty. This study showed that the health care safety net in South Korea was insufficient for disabled elderly households and that a policy should be established in ordered to protect disabled elderly households from occurrence of Catastrophic Health Expenditure.

본 연구는 장애노인의 과부담 보건의료비 현황 및 영향요인을 밝히기 위한 목적으로 진행되었다. 과부담 보건의료는 지불능력 대비 가구 보건의료비 지출이 역치기준(10%, 20%, 30%, 40%)을 초과한 상태로 정의하였다. 본 연구는 장애인고용패널조사 1, 2, 3차년 통합자료를 활용하였으며, 연구대상으로 60세 이상의 장애노인 726명을 분석대상으로 삼았다. 장애노인가구의 과부담 보건의료비 영향요인을 밝히기 위하여 패널로짓분석을 사용하였다. 연구결과 연령이 높을수록, 배우자가 있을 때, 내부 장애인의 경우, 건강상태가 나쁠 때, 만성질환이 있을 때, 가구원 수가 많을수록, 장애가족비율이 높을수록, 노인가족비율이 높을수록, 빈곤유형 중 빈곤 비수급가구에 속할 때 과부담 보건의료비 위험이 높아지는 것으로 나타났다. 연구결과에 기초하여 우리나라의 장애노인 가구의 과부담 보건의료비 경감을 위한 제언을 제시하였다.