• Health Policy and Management
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• v.12 no.1
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• pp.1-20
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• 2002

National health expenditure account describes expenditure flows both public and private within the health sector. It describes the sources and uses and channels for all funds utilized in the health sector and is a basic requirement for optimal management of the allocation of health sector resources. Constructing a national health expenditure account should begin with sound estimates. This paper thoroughly examines the sources and discusses the estimation methods, and provides the national health expenditure account of Korea by function and source of funding category The national health expenditure account produced in this parer has, however, some drawbacks and followings are proposed fur enhancing the comprehensiveness and consistency of the account. First, comparable data un health related expenditures of local government and private sector should be produced because data sets on the sectors are very limited. Second, we need further study un overall scope and boundaries of health expenditure estimates in order to improve compatibility of other main aggregates.

• Health Policy and Management
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• v.28 no.1
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• pp.95-97
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• 2018

Catastrophic health expenditure refers to when a household spends more than 40 percent of disposable income for out-of-pocket-expenses for healthcare. This study investigates the percentage of South Korean household which experienced the catastrophic health expenditure between 2006 and 2016 with the National Survey of Tax and Benefit and the Household Income and Expenditure Survey data. Percentage of households with the catastrophic health expenditure and tread tests were conducted with weight variable. The results of the National Survey of Tax and Benefit and the Household Income and Expenditure Survey showed 2.17% and 2.92% of households experienced the catastrophic health expenditure in 2016. In trend analysis, the National Survey of Tax and Benefit showed a statistically significant decreasing trend in the proportion of households with the catastrophic health expenditure (annual percentage change [APC]=-4.03, p<0.0001). However, the Household Income and Expenditure Survey revealed a statistically significant increasing trend (APC=1.43, p<0.0001). In conclusion, this study suggests that optimal healthcare alternatives are needed for the catastrophic health expenditure and monitoring low-income households.

• Health Policy and Management
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• v.29 no.1
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• pp.86-89
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• 2019

Catastrophic health expenditure refers to spending more than a certain level of household's income on healthcare expenditure. The aim of this study was to investigate the proportion of households that experienced catastrophic health expenditure between 2006 and 2017 with the National Survey of Tax and Benefit (NaSTaB) and between 2011 to 2016 using Households Income and Expenditure Survey (HIES) data. The results of the NaSTaB showed 2.16% of households experienced the catastrophic health expenditure in 2017. In trend analysis, the NaSTaB revealed a statistically significant decreasing trend (annual percentage change [APC] = -2.01, p<0.001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92% of households experienced the catastrophic health expenditure in 2016. Also, there was a slightly increasing trend (APC= 1.43, p<0.001). In subgroup analysis, groups with lower income levels were likely to experience catastrophic health expenditure. In conclusion, further public support system is needed to lower experience these healthcare expenditures and monitor the low income group.

• Health Policy and Management
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• v.24 no.3
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• pp.242-253
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• 2014

Background: The low benefit coverage rate of South Korea's health security system causes catastrophic health expenditure. And catastrophic health expenditure can be the cause of the transition to and persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to and persistence of poverty, using 6 years of the Korea Welfare Panel Study Data. Methods: This study was conducted among the 22,528 households that participated in the Korea Welfare Panel Study, 2007-2012. Catastrophic health expenditure was defined as equal to or exceeds thresholds (10%, 20%, 30%, and 40%) of household's capacity to pay. The effect of catastrophic health expenditure on the transition to and persistence of poverty was ascertained via multivariate logistic regression. Results: Four-point-seven percent to 20.6% of the households are facing catastrophic health expenditure. Rates of the transition to (relative risk [RR], 18.6 to 30.2) and persistence of (RR, 74.8 to 76.0) poverty of households facing catastrophic health expenditure was higher than households not facing catastrophic health expenditure. Even after adjusting the characteristics of the household and the household head, catastrophic health expenditure was found to affect transition to (odds ratio [OR], 2.11 to 3.04) and persistence of (OR, 1.53 to 1.70) poverty. Conclusion: To prevent catastrophic health expenditure and transition to and persistence of poverty resulting from catastrophic health expenditure, the reinforcement of South Korea's health security system including the benefit coverage enhancement is required.

• Health Policy and Management
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• v.13 no.4
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• pp.48-65
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• 2003

Detailed analyses of total health expenditure and its sub­categories are essential for the evidence­based health policy(EBHP). These analyses, again, should be based on timely and reliable data that are comparable across countries. The System of Health Accounts (SHA), published by the OECD in 2000, provides an integrated system of comprehensive and internationally comparable accounts. The author has implemented the SHA manual into Korean situation, and examined overall expenditure estimate and its basic functional breakdown following the manual. This study explains how pharmaceutical expenditure is estimated. The results are, then, analyzed particularly from the international perspective. Both administrative data in Statistical Yearbooks (National Health Insurance, Medical Aid, Industrial Accident Compensation Insurance) and survey data on Health and Nutrition are used for the estimation. Per capita pharmaceutical expenditure in Korea (183 US$ PPPs) was far less than the OECD average (308 US$ PPPs) in 2001, but pharmaceutical expenditure share in total health expenditure (20.3％) was higher than the average (16.7％). This can be explained by the fact that there is a statistically significant correlation between pharmaceutical expenditure share and per capita GDP of each country. Korean people follow the tendency of relatively low­income countries to spend less than OECD average for health care, but follow again their tendency to spend more on drugs than on other health care services. In consideration of results and analysis as above, per capita pharmaceutical expenditure in Korea is expected to grow in the future, but the growth rate of the pharmaceutical expenditure is expected to be less than that of overall health expenditure.

• Health Policy and Management
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• v.30 no.1
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• pp.126-130
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• 2020

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2018 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. The households experienced the catastrophic health expenditure 2.08% in 2018 using the NaSTaB data. Trend analysis was significant with the decreasing trend (Annual Percentage Change [APC], -4.88; p<0.0001) in the proportion of households with the catastrophic health expenditure. On the other hand, the results of the HIES showed 2.92%, and KHP showed 2.48% of households experienced the catastrophic health expenditure in 2016. The trend was significantly increased in HIES (APC, 1.43; p<0.0001) and KHP (APC, 6.68; p<0.0001). Therefore, this suggests that further interventions to alleviate the burden of catastrophic health expenditure to the low-income group are needed.

• Journal of Families and Better Life
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• v.28 no.1
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• pp.159-174
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• 2010

The purpose of this study was to examine the health care expenditure of elderly single and elderly couple households whose head is more than 60 years old. The data analyzed for the study were Korean Retirement and Income Study(KRelS) conducted in 2007 by National Pension Corporation. The major finding of this study were as follows: First, the amount of health care expenditure of elderly single households was lower than that of elderly couple households. However, ratio of health care expenditure to total consumption expenditure of elderly single households was larger than that of elderly couple households. Second, the ratio of health care expenditure in consumption expenditure in this study was larger than the ratios in past analyse showed in the previous studies. Third, common factor affecting on health care expenditure of elderly single and elderly couple households was the existence of the family member with chronic disease or handicap. The health care expenditure of elderly singer households was influenced by income, gender and the ownership of national health insurance. The influence of income for elderly singer households seemed to be greater than for elderly couple households. The variables which affected health care expenditure of elderly couple households were age and housing tenure status. The amount and ratio health care expenditure were increased as the age increases. These results show that the health care expenditures for each groups varied according to socio-demographic variables and health-related behavior variables. It is suggested that there should be a discriminative health care policy for each elderly single and elderly couple households. In addition, the health care policy for the elderly households of which member has a chronic disease is certainly necessary. Especially a health care plan for the elderly single households with lower income is in need. For the elderly couple households, the priority group of health care policy would be the high age group.

• Health Policy and Management
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• v.20 no.3
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• Health Policy and Management
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• v.31 no.1
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• pp.140-144
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• 2021

Catastrophic health expenditure refers to measure the level of the economic burden of households due to medical expenses. The purpose of this study was to examine the proportion of households that experienced catastrophic health expenditure between 2006 and 2019 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of households with catastrophic healthcare expenditure. The households experienced a catastrophic health expenditure of 2.44% in 2019 using the NaSTaB data. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -4.49; p<0.0001) in the proportion of households with catastrophic health expenditure. Also, the results of the 2017 KHP and the 2016 HIES showed 2.20% and 2.92%. The trend was significantly increased in the KHP (APC, 1.79; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, this study suggests that further public healthcare interventions to alleviate the burden of catastrophic health expenditure, especially for low-income households, are needed.

• Health Policy and Management
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• v.32 no.1
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• pp.107-112
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• 2022

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2020 using available data from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). Trend test was used to analyze the proportion of household with catastrophic healthcare expenditure. In the NaSTaB 2020 data, households who experienced catastrophic health expenditure was 1.73%. Trend analysis was significant with the decreasing trend (annual percentage change [APC], -5.55; p<0.0001) in the proportion of households with the catastrophic health expenditure. Also, in the 2018 KHP and the 2016 HIES, households who experienced catastrophic health expenditure was 2.21% and 2.92% respectively. In contrast, the trend was significantly increased in the KHP (APC, 0.55; p<0.0001) and the HIES (APC, 1.43; p<0.0001). Therefore, the findings suggest the need to strengthen public health care financial support and monitor catastrophic healthcare expenditures, especially for low-income group.