• Health Policy and Management
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• v.28 no.4
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• pp.327-328
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• 2018

The quality of healthcare in Korea is very good, especially in life threatening disease. However, the level of healthcare research in Korea is not good relative to that of engineering. International university rankings also were showed that engineering was generally higher ranking than medicine. The reason of this phenomenon was deeply related to expenditure on research and development (R&D). Although Korea had a lot of gross domestic expenditure on R&D (GERD), 75% of GERD was from business enterprise that was related to engineering. Healthcare expenditure of R&D from business enterprise is small. Healthcare expenditure from government budget allocation on R&D (GBARD) was smaller than engineering. Higher education expenditure on R&D of GERD was also small and the quantity and quality of researcher in higher education was not enough. For Korea's healthcare to become the growth engine for future, GBARD should be invested heavily in the healthcare, a large part of the increased GBARD must be invested in higher education, and the higher education should invest to secure the higher quality researcher stably.

• Health Policy and Management
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• v.27 no.1
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• pp.84-87
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• 2017

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 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change= 0.92%, p-value < 0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.

• 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.

• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• Health Policy and Management
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• v.28 no.4
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• pp.378-391
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• 2018

Background: People who were born in different years, that is, different birth cohorts, grow in varying socio-historical and dynamic contexts, which result in differences in social dispositions and physical abilities. Methods: This study used age-period-cohort analysis method to establish explanatory models on healthcare expenditure in Korea reflecting birth cohort factor using intrinsic estimator. Based on these models, we tried to investigate the effects of ageing population on future healthcare expenditure through simulation by scenarios. Results: Coefficient of cohort effect was not as high as that of age effect, but greater than that of period effect. The cohort effect can be interpreted to show 'healthy ageing' phenomenon. Healthy ageing effect shows annual average decrease of -1.74% to 1.57% in healthcare expenditure. Controlling age, period, and birth cohort effects, pure demographic effect of population ageing due to increase in life expectancy shows annual average increase of 1.61%-1.80% in healthcare expenditure. Conclusion: First, since the influence of population factor itself on healthcare expenditure increase is not as big as expected. Second, 'healthy ageing effect' suggests that there is a need of paradigm shift to prevention centered-healthcare services. Third, forecasting of health expenditure needs to reflect social change factors by considering birth cohort effect.

• Korea Journal of Hospital Management
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• v.24 no.2
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• pp.1-11
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• 2019

Purpose: The purpose of this study is to identify relationship between work unstability and personal medical expenditure ratio focusing on wage workers' contract period. Method: This study analyzed 2015 yearly data beta version of Korea Health Panel, co-managed by Korea Institute for Health and Social Affairs and National Insurance Corporation for data analysis. When executing linear regression, Household income was applied with equivalized income, and the proportion of personal medical expenditure was naturally logged to perform linear regression and the demographic and socioeconomic factors were taken into account. The demographic and socio-economic factors were also considered. Findings: As a result of reviewing the used factors, it was found that the more unstable work status, the higher personal medical expenditure ratio. This result corresponds to 'The Theory of Fundamental Causes' by Link & Phelan. Conclusion : It indicates that policy efforts should be made to improve the working environment and health level of socially unstable workers.

• 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.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.

• Journal of Family Resource Management and Policy Review
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• v.23 no.1
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• pp.17-34
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• 2019

Older women who live alone are among society's most vulnerable people, since they experience increased risk of multiple chronic diseases and have limited financial protection. This can lead older women living alone to catastrophic health expenditure(CHE), which is defined as a healthcare expenditure that exceeds a certain portion of a household's ability to pay. Using the Korean Longitudinal Study of Ageing(KLoSA), this study investigated the incidence of CHE among older women living alone and identified the factors related to this incidence. Applying health expenditure thresholds of 10%, 20%, 30% and 40% of ability to pay, the proportions of those with CHE were 41.3%, 22.9%, 14.6%, and 9.4%, respectively. Logistic regression models were used to identify factors related to CHE incidence, which include demographics, income, the number of chronic diseases, perceived health status, and health insurance type. The results show that the health care safety net in South Korea is insufficient for older women living alone. The findings can guide policymakers in improving healthcare and welfare policies to protect people from catastrophic payments. Particularly, welfare policies should be established for poor non-recipients who are not included within the benefits scope of the National Basic Livelihood Security System due to the unrealistic criteria of income recognition and family support obligation.