• Health Policy and Management
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• v.18 no.3
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• pp.110-127
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• 2008

Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

• Journal of Family Resource Management and Policy Review
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• v.14 no.1
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• pp.135-159
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• 2010

The purpose of the study was to investigate the characteristics and economic status of deficit households compared to surplus households. Data from The Household Income and Expenditure Survey 2005 by NSO and 50, 207 salary/wage earners' households were used for the analysis. The statistical methods used were GLM, logit, and cluster analyses. The analysis results showed that 25.3 percent of the households were deficit households. Approximately half of the lowest 20% income group were deficit households. Income deficit households earned 1, 273 thousand less than that of surplus households, whereas consumption of deficit households was 1, 006 thousand more than that of surplus households. The average propensity of consumption of deficit households was 142.1. According to the logit analysis, factors contributing to the probability of belonging to a deficit household included income level, household size, age and educational level, occupation, homeownership, car ownership, and wife's employment status. Deficit households were classified into 5 types: 1) health care expenditure-dominated group, 2) housing expenditure-dominated group, 3) education expenditure-dominated group, 4) money transfer-dominated group, and 5) overall-overconsumption group. The overall-overconsumption group was the largest group of all at 58.5%. It was found that for all five groups, the changes in household size, income group, home ownership, and occupation of the individual were variables that influenced the probability of belonging to a certain group.

• 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.20 no.1
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• pp.37-63
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• 2010

Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.

• 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.

• 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.

• Journal of Families and Better Life
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• v.33 no.1
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• pp.19-39
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• 2015

The purpose of the study was to examine the characteristics and economic status of deficit households. The data for this study were from The Household Income and Expenditure Survey in 2000, 2005, and 2010 conducted by the National Statistics Office (NSO). Deficit households were defined by those who had expenditures higher than their income. Among total households, the proportion of deficit households was 26.84% in 2000, 28.14% in 2005, and 27.15% in 2010. The average propensity to consume was 132.1 in 2005, which was higher than those in 2000 and 2010. Deficit households were classified into five types using cluster analysis: 1)overall-overconsumption group(33.07%), 2)basic needs group(26.33%), 3)transportation expenditure-dominated group(6.73%), 4)education expenditure-dominated group(27.63%), 5)health care expenditure-dominated group(6.24%). The overall-overconsumption group was the largest group of total households and the portion of this group among total households decreased by 4.97%p from 2005 to 2010. However, the education expenditure-dominated group increased by approximately 7.6%p over the period. It was also found that households in 2000 and 2010 were more likely to be in all five groups than households in 2005. Other major determinants of households with deficit were gender, age, number of family members, education level, dual income, home ownership, vehicle ownership, and income class.

• 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.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.91-102
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• 1993

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered questionnaires completed by housewives. The survey was conducted from March 1 to May 31, 1992. The mean age was 31.1 years in the poor area and 37.1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The average monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%), while hospital and clinic(37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2.800 Won in the poor area and 6,300 Won in the control area.

• 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.