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The Effect of Catastrophic Health Expenditure on the Transition to and Persistence of Poverty in South Korea: Analysis of the Korea Welfare Panel Study Data, 2007-2012

재난적 의료비 지출이 빈곤화 및 빈곤 지속에 미치는 영향: 복지패널 2007-2012년 자료 분석

  • 송은철 (구로구 보건소) ;
  • 신영전 (한양대학교 의과대학 예방의학교실)
  • Received : 2014.06.19
  • Accepted : 2014.09.04
  • Published : 2014.09.30

Abstract

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.

Keywords

References

  1. Kim CY. Theories of health security. Paju: Hanul publishing Co.; 2009.
  2. Kim CY, Lee JS, Kang GW, Kim YI. Magnitude of patient's cost-sharing for hospital services in the national health insurance in Korea. Korean J Health Policy Admin 1999;9(4):1-14.
  3. Shin YS, Shin HW, Hwang DK, Kim HI, Kim JS. Establishment of the health care safety net and policy task. Seoul: Korea Institute for Health and Social Affairs; 2006.
  4. Shin YJ. Health care safety net in Korea: issues and policy options. Health Welf Policy Forum 2009;155:17-28.
  5. Song EC, Kim CY, Shin YJ. The effect of health care expenditure ¡on income inequality. Korean J Health Policy Admin 2010;20(3):36-57. https://doi.org/10.4332/KJHPA.2010.20.3.057
  6. Park IH. Analysis on the level of national health expenditure and associated factors in the OECD countries. Korean J Health Policy Admin 2012; 22(4):538-560. https://doi.org/10.4332/KJHPA.2012.22.4.538
  7. Shin YS. Policy measures of medical safety net for low-income and underprivileged brackets. Health Welf Policy Forum 2012;185:6-14.
  8. Shin HW, Yeo JY. Health security and policy issues. Health Welf Policy Forum 2014;207:5-16.
  9. Suhrcke M, Rocco L, McKee M. Health: a vital investment for economic development in eastern Europe and central Asia. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies; 2008.
  10. Wagstaff A, van Doorslaer E. Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ 2003;12(11):921-934. DOI: http://dx.doi.org/10.1002/hec.776
  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: http://dx.doi.org/10.1016/s0140-6736(03)13861-5
  12. Lee TJ, Yang BM, Kwon SM, Oh JH, Lee SH. Equity in the expenditures of health care services. Korean Health Econ Rev 2003;9(2):25-24.
  13. Lee WY. Equity in catastrophic health expenditure [dissertation]. Seoul: Hanyang University; 2004.
  14. Lee WY. Equity in urban households' out-of-pocket payments for health care. Korean J Health Policy Admin 2005;15(1):30-56. https://doi.org/10.4332/KJHPA.2005.15.1.030
  15. Lee WY, Shin YJ. Catastrophic health expenditure among income groups in urban households. Korean Soc Sec Stud 2005;21(2):105-133.
  16. Kim HJ. Household medical expenditure burden of the poor. J Soc Res 2008;9(1):229-254.
  17. Kim YH, Yang BM. The trend in catastrophic health payments by income strata in South Korea. Korean J Health Econ Policy 2009;15(1):59-77.
  18. Sohn SI, Shin YJ, Kim CY. Factors influencing household catastrophic health expenditure of the poor. Health Soc Welf Rev 2010;30(1):92-110. https://doi.org/10.15709/hswr.2010.30.1.92
  19. Song EC, Shin YJ. The effect of catastrophic health Expenditure on the Transition to Poverty and the Persistence of Poverty in South Korea. J Prev Med Public Health 2010; 43(5): 423-435. https://doi.org/10.3961/jpmph.2010.43.5.423
  20. Shin HW, Shin YS, Hwang DK, Yoon PK. The effects of catastrophic health expenditure on poverty. Seoul: Korea Institute for Health and Social Affairs; 2010.
  21. Choi JK, Jeong HS, Shin JW, Yeo JY. Effects of the benefit extension policy on the burdening of health care expenditure for households with patients of chronic or serious case. Korean J Health Policy Admin 2011;21(2):159-178. https://doi.org/10.4332/KJHPA.2011.21.2.159
  22. Kim KS, Lee HO. Household catastrophic health expenditure and unmet needs depending on the types of health care system. Soc Welf Policy 2012;39(4):255-279. https://doi.org/10.15855/swp.2012.39.4.255
  23. Roh SH. The longitudinal study on the factors of catastrophic health expenditure among disabled elderly households. Korean J Soc Welf 2012; 64(3):51-77. https://doi.org/10.20970/kasw.2012.64.3.003
  24. Lee TJ, Lee HJ, Kim YH. Analysis of catastrophic health expenditure using 1st wave Korea health panel data. Korean J Health Econ Policy 2012; 18(1):95-111.
  25. Lee HJ, Lee TJ. Factors associated with incidence and recurrence of household catastrophic health expenditure in South Korea. Korean Soc Secur Stud 2012;28(3):39-62.
  26. Cheong CL, Lee TJ. The factors influencing the occurrence and recurrence of catastrophic health expenditure among households in Seoul. Korean J Health Policy Admin 2012;22(2):275-296. https://doi.org/10.4332/KJHPA.2012.22.2.275
  27. Park JY, Kim YM, Jung KT. A study on the determinants of catastrophic health expenditure of the middle- and old-aged household. Health Serv Manag Rev 2013;7(2):25-37. https://doi.org/10.18014/HSMR.2013.7.2.25
  28. Jung YI, Lee HJ, Lee TJ, Kim HS. Measures of household catastrophic health expenditure: systematic review and implications. Korean J Health Econ Policy 2013;19(4):1-27.
  29. Ku IH. Socio-economic characteristics of the poor and poverty transition in Korea: since the recent economic crisis. Korean J Soc Welf 2002;48:82-112.
  30. Ku IH. Poverty dynamics in Korea: poverty duration and its determinants. Korean J Soc Welf 2005;57(2):351-374.
  31. Kim AR. A study on poverty duration and its determinants: focusing on type of household [dissertation]. Seoul: Seoul National University; 2006.
  32. Seok SH. Testing for state dependence effects in poverty dynamics. Korean Soc Secur Stud 2007;23(3):79-99.
  33. Kim KS, Noh HJ. An empirical study of poverty exit and duration: life table analysis and hierarchical generalized linear analysis. Soc Welf Policy 2009;36(3):185-212. https://doi.org/10.15855/swp.2009.36.3.185
  34. Park, ME, Shin HJ. Experiences of social exclusion in pauperization of female Householders. J Soc Sci 2010;36(3):167-193. https://doi.org/10.15820/khjss.2010.36.3.008
  35. Kim, SY, Huh S. Factors influencing poverty of the class of elderly working poor. J Welf Aged 2010;47:375-398.
  36. Ban JH. A study on the income variation and the poverty of self-employed households: based on the comparison of paid worker households. Q J Labor Policy 2012;12(1):29-56.
  37. Kim JH. Impoverishment of unprivileged divorcees: their social exclusion experience in family and labor market. Korean J Fam Soc Work 2012;38: 69-102.
  38. Kim MS, Bae HO. Poverty status changes of the families with children. J Korean Counc Child Rights 2012;16(3):497-521.
  39. Korea Welfare Panel Study. Korea Welfare Panel Study user's guide. Seoul: Korea Institute for Health and Social Affairs, Institute of Social Welfare, Seoul National University; 2013.
  40. Lee BJ, Kang SK, Ku IH, Kim TS, An SH, Son BD, et al. An in-depth study of 2006 Korea Welfare Panel Study. Seoul: Department of Social Welfare, Seoul National University; 2007.
  41. Li Y, Wu Q, Liu C, Kang Z, Xie X, Yin H, et al. Catastrophic health expenditure and rural household impoverishment in China: what role does the new cooperative health insurance scheme play? PLoS One 2014;9(4):e93253. DOI: http://dx.doi.org/10.1371/journal.pone.0093253
  42. Weraphong J, Pannarunothai S, Luxananun T, Junsri N, Deesawatsripetch S. Catastrophic health expenditure in an urban city: seven years after universal coverage policy in Thailand. Southeast Asian J Trop Med Public Health 2013;44(1):124-136.
  43. Raban MZ, Dandona R, Dandona L. Variations in catastrophic health expenditure estimates from household surveys in India. Bull World Health Organ 2013;91(10):726-735. DOI: http://dx.doi.org/10.2471/blt.12.113100.
  44. Kavosi Z, Rashidian A, Pourreza A, Majdzadeh R, Pourmalek F, Hosseinpour AR, et al. Inequality in household catastrophic health care expenditure in a low-income society of Iran. Health Policy Plan 2012;27(7):613-623. DOI: http://dx.doi.org/10.1093/heapol/czs001
  45. Onoka CA, Onwujekwe OE, Hanson K, Uzochukwu BS. Examining catastrophic health expenditures at variable thresholds using household consumption expenditure diaries. Trop Med Int Health 2011;16(10):1334-1341. DOI: http://dx.doi.org/10.1111/j.1365-3156.2011.02836.x
  46. Bredenkamp C, Mendola M, Gragnolati M. Catastrophic and impoverishing effects of health expenditure: new evidence from the Western Balkans. Health Policy Plan 2011;26(4):349-356. DOI: http://dx.doi.org/10.1093/heapol/czq070
  47. Organization for Economic Cooperation and Development. Health at a glance 2013: OECD indicators. Paris: OECD Publishing; 2013.

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  1. The Effect of Occurrence and Reoccurrence of Catastrophic Health Expenditure on Transition to Poverty and Persistence of Poverty in South Korea vol.26, pp.3, 2016, https://doi.org/10.4332/KJHPA.2016.26.2.172