• Korean Journal of Social Welfare
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• v.64 no.3
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• pp.51-77
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• 2012

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.

• The Journal of the Korea Contents Association
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• v.22 no.1
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• pp.484-492
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• 2022

In this study, we used the Korea Health Panel Study for 2017 raw data as analytical data to understand the factors that affect the catastrophic health expenditures of the baby boomer generation and the final number of analyzed was 808 people. Analysis methods performed frequency analysis, crosstabulation, and multiple regression analysis, with p = .05 at the significance level for all validations. The statistically significant differences among the baby boomer generation were education level, marriage status, health insurence, household income, drinking, smoking, subjective health, outpatient care, and inpatient care. The average number of illnesses in the baby boomer generation was 8.14, of which 7.97 for male and 7.97 for female. The average number of outpatient visits was 16.81, of which 14.81 recalls for male and 26.89 for female. More than 40% of the ability to pay the catastrophic health expenditures rate was 15.3% for male and 26.3% for female. The factors affecting the catastrophic health expenditure of babyboomer generation are as follows. that influence the widow's fence medical expenses are as follows. Male were private insurance, household income, drinking, and inpatient care, and female were private insurance, household income, and drinking.

• Health Policy and Management
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• v.21 no.2
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• pp.159-178
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• 2011

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.

• Health Policy and Management
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• v.22 no.2
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• pp.275-296
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• 2012

Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X${\geq}$10%), 5.34% (T/X${\geq}$20%), 6.84% (T/Y${\geq}$25%), and 4.44% (T/Y${\geq}$40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.

• Health Policy and Management
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• v.24 no.1
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• pp.56-70
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• 2014

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.