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http://dx.doi.org/10.4332/KJHPA.2011.21.2.159

Effects of the benefit extension policy on the burdening of health care expenditure for households with patients of chronic or serious case  

Choi, Jung-Kyu (Department of Health Administration, Yonsei University)
Jeong, Hyoung-Sun (Department of Health Administration, Yonsei University)
Shin, Jeong-Woo (Department of Health Administration, Yonsei University)
Yeo, Ji-Young (Department of Health Administration, Yonsei University)
Publication Information
Health Policy and Management / v.21, no.2, 2011 , pp. 159-178 More about this Journal
Abstract
Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in 'out-of-pocket expenditure as a share of the ability to pay' and 'incidence rate of catastrophic health care expenditure' of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare Panel Study (KoWePS), conducted by the Korea Institute for Health and Social Affairs (KIHASA), were used for the analysis, where low-income households and ordinary households are sampled separately. While the absolute amount of 'out-of-pocket expenditure' occurred to the average household increased for the period 2005-2007, the 'out-of-pocket expenditure as a share of the ability to pay' decreased. At the same time, the share decreased in the case of low-income households and households with patients of chronic or serious case as contrasted with ordinary households. 'Incidence rates of catastrophic health care expenditure' of ordinary households for 2007 stood at 14.6%, 5.9% and 2.8% at the threshold of 10%, 20% and 30%, respectively. The rates decreased overall between 2005 and 2007, while those of low-income households with patients of serious case statistically significantly increased. An analysis of this study indicates that it is related with the medical bill ceiling system regardless of incomes introduced in 2007.
Keywords
benefit extension policy; catastrophic health care expenditure; chronic patient; serious case;
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Times Cited By KSCI : 5  (Citation Analysis)
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1 Wyszewianski. Families with Catastrophic Health Care Expenditure. Health Service Research 1986; 21(5): 617.
2 Ziller EC, Coburn AF, Yousefian AE. Out-of-pocket health spending and the rural underinsured. Health Affairs 2006; 25(6): 1688-1699.   DOI   ScienceOn
3 Knaul FM, Arreola-Ornelas H, Mndez-Carniado O, Bryson-Cahn C, Barofsky J, Maguire R, et al. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico. Lancet, 2006; 368(9549): 1828-1841.   DOI   ScienceOn
4 Limwattananon S, Tangcharoensathien V, Prakongsai P. Catastrophic and poverty impacts of health payments: results from national household surveys in Thailand. Bull World Health Organ 2007; 85(8): 600-606.   DOI   ScienceOn
5 OECD. OECD Health Data; 2009.
6 Somkotra T, Lagrada LP. Payments for health care and its effect on catastrophe and impoverishment: experience from the transition to Universal Coverage in Thailand. Soc Sci Med 2008; 67(12): 2027-2035.   DOI   ScienceOn
7 Su, T. T., Kouyat, B., & Flessa, S. Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso. Bulletin of the World Health Organization, 2006; 84:. 21-27.
8 van Doorslaer E, O'Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, et al. Catastrophic payments for health care in Asia. Health Economics 2007; 16(11): 1159-1184.   DOI   ScienceOn
9 Wagstaff A, van Doorslaer E. Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Economics 2003; 12(11): 921-934.   DOI   ScienceOn
10 Xu K. Distribution of Health Payments and Catastrophic Expenditures Methodology. WHO; 2005.
11 Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a multicountry analysis. Lancet 2003; 362(9378): 111-117.   DOI   ScienceOn
12 Xu K, Evans DB, Carrin G, Agullar-Rivera AM, Musgrove P, Evans T. Protecting Households From Catastrophic Health Spending. Health Affairs 2007; 26(4): 972-983.   DOI   ScienceOn
13 정형선. 건강보험 보장성 지표 개발연구. 서울: 국민건강보험공단; 2010.
14 지은정. 의료비 지출이 종사상 지위 및 소득변화에 미치는 요인연구. 한국사회복지학 2004; 56(3): 5-35.   과학기술학회마을
15 한국보건사회연구원, 서울대학교 사회복지연구소. 1, 3차년도 한국복지패널 조사자료 사용자 지침서. 서울: 보건사회연구원; 2006, 2008.
16 허순임, 김창보. 우리나라 건강보험 보장성 개선 정책에 대한 평가. 보건행정학회지 2009; 19(3): 142-165.   과학기술학회마을   DOI   ScienceOn
17 Berki SE. A look at catastrophic medical expenses and the poor. Health Affairs 1986; 5(4): 138-145.   DOI
18 Chu, T. B., T.C. Liu, C.S. Chen, Y.W. Tsai, and W.T. Chiu. Household out-ofpocket medical expenditures and National health Insurance in Taiwan: income and regional inequality. BMC Health Services Research, 2005; 5(60).
19 Feenberg, D., & Skinner, J. The Risk and Duration of Catastrophic Health Care Expenditures. The Review of Economics and Statistics, 1994; 76(4): 633-647.   DOI   ScienceOn
20 Feldstein, PJ. Health Care Economics: 6th Edition, Delmar Learning; 2004.
21 국민건강보험공단. 건강보험 보장성 정책 평가 및 확대 대상 검토. 서울; 국민건강보험공단: 2009.
22 Goldman DP, Zissimopoulos JM. High out-of-pocket health care spending by the elderly. Health Affairs 2003; 22(3): 194-202.   DOI   ScienceOn
23 Gross DJ, Alecxih L, Gibson MJ, Corea J, Caplan C, Brangan N. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries. Health Serv Res 1999; 34(1): 241-254.
24 Kawabata, K., Ke X., & Guy, C. Preventing impoverished through protection against catastrophic health expenditure. WHO. Bulletin of the World Health Organization, 2002; 80(8): 612.
25 국민건강보험공단. 소득수준별 본인부담상한제 차등 적용 방안. 서울; 국민건강보험공단: 2008.
26 김태일, 허순임. 소득 계층별 의료비 부담의 추이와 정책 과제. 보건행정학회지 2008; 18(4): 23-48.   DOI
27 김학주. 계층간 진료비 본인부담의 형평성에 관한 연구. 한국사회복지학회지 2004; 56(3): 113-133.   과학기술학회마을
28 김학주. 빈곤층의 의료비지출 과부담에 관한 연구. 한국사회 2008; 9(1): 229-254.
29 보건복지부. 2005 건강보험 보장성 강화방안. 서울; 보건복지부: 2005.
30 보건복지부 중앙생활보장위원회. 2010 최저생계비 보도자료. 서울; 보건복지부: 2010.
31 손수인, 신영전, 김창엽. 저소득층의 과부담 의료비 발생에 영향을 미치는 요인. 보건사회연구 2010; 30(1): 92-110.   DOI
32 이수연. 의료서비스 이용 및 치료비 부담률의 비형평 원인에 관한 연구. 사회복지연구 1997; 10(1): 415-447.
33 이용재. 본인부담경감이 암 환자의 건강보험이용에 미친 영향. 한국재정정책학회지 2009; 11(1): 3-25.
34 이원영. 도시가계 의료비 지출의 형평성. 보건행정학회지 2005; 15(1): 30-56.   DOI
35 윤희숙. 건강보험 보장성 강화 정책의 방향과 의사결정방식의 문제점. 의료정책포럼 2007; 5(2): 81-86.
36 이원영, 신영전. 도시가계 소득계층별 과부담 의료비 실태. 사회보장연구 2005; 21(2): 105-133.
37 이태진, 양봉민, 권순만, 오주환, 이수형. 보건의료 비용 지출의 형평성. 보건경제연구 2003; 9(2): 25-34.