Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Impact of Public Transfer Income on Catastrophic Health Expenditures for Households With Disabilities in Korea

  • Eun Jee Chang (Graduate School of Public Health, Seoul National University) ;
  • Sanggu Kang (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Yeri Jeong (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Sungchan Kang (Graduate School of Public Health, Seoul National University) ;
  • Su Jin Kang (Institute of Health and Environment, Seoul National University)
  • Received : 2022.08.10
  • Accepted : 2022.10.21
  • Published : 2023.01.31
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Abstract

Objectives: Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities. Methods: We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types. Results: As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001). Conclusions: This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.

Keywords

Acknowledgement

This paper is based on "The impact of public transfer income on catastrophic health expenditure for households with disabilities", the lead author's master's thesis at the Graduate School of Public Health, Seoul National University.

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