DOI QR코드

DOI QR Code

Inequity Trend on Medical Utilization by Diseases

질병에 따른 소득분위별 의료이용 불평등도 추이

  • Kim, Younjoo (Department of Public Health, Graduate School, Kyungpook National University) ;
  • Lee, Won Kee (Department of Preventive Medicine, School of Medicine, Kyungpook National University) ;
  • Kam, Sin (Department of Preventive Medicine, School of Medicine, Kyungpook National University)
  • 김윤주 (경북대학교 대학원 보건학과) ;
  • 이원기 (경북대학교 의과대학 예방의학교실) ;
  • 감신 (경북대학교 의과대학 예방의학교실)
  • Received : 2018.07.31
  • Accepted : 2018.08.28
  • Published : 2018.08.31

Abstract

Objectives: Equal medical access to equal medical needs is critical to health care. The purpose of this study was to investigate the inequity trend on medical utilization by diseases. Methods: We estimated the horizontal equity of subjects over 20 years old and the medical service frequency and medical expenditure by disease using the Korea Health panel data from 2009 to 2014. Results: The horizontal equity index of medical expenditure was shown to be a negative (-) number of both the actual and necessary personal medical expenditure over six years from 2009 to 2014, with lower actual expenditure than required in low-income level. However, the absolute number was decreasing more and more over the years, so it was becoming balanced on horizontal equity. The horizontal equity index of medical service frequency was 0.016 in 2009, showing a pro-rich tendency to use more medical service in high-income level, and a pro-poor trend in 2014 -0.006, which means more medical service use in low-income level. Conclusions: Therefore, it is estimated that the horizontal equity index on medical expenditure by income level is gradually decreasing due to the effect of various policy for reducing the patient's own burden rate. Thus, if there is the same medical expenditure when using medical services for equal medical needs, the burden on the lower income class would be greater than the burden on the upper income. So it should be sustainedly implemented the policies with reducing the burden on medical expenditures for the lower income groups.

Keywords

References

  1. World Health Organization. Constitution of the World Health Organization. Geneva: World Health Organization; 1948.
  2. Kim DJ. Medical utilization in Korea and health inequality. Health and Social Welfare Issue & Focus 2015;280 (Korean).
  3. Lee HS, Choi YJ. A study on the medical expenses and unmet medical experience: applying on measurement of the catastrophic expenditure reflection private health insurance. J Crit Soc Policy 2017;55(5):7-38 (Korean).
  4. Shin YS, Kim YY, Gang YH, Kim MH, Kang MA, Go KW, et al. Health policy and management. 3rd ed. Seoul: Seoul National University Press; 2013 (Korean).
  5. Organization for Economic Co-operation and Development (OECD). OECD health data 2016. Paris: Organization for Economic Co-operation and Development; 2017.
  6. The Ministry of Health and Welfare and Korea Institute for Health and Social Affairs. 2017 Social security factbook. Sejong: Ministry of Health and Welfare and Korea Institute for Health and Social Affairs; 2017 (Korean).
  7. Kang HJ. Current state and challenges of National Health Insurance. Health and Social Welfare Forum 2016;15-30 (Korean).
  8. Lee SH, Kam S, Lee WK. The trend in household catastrophic medical expenditure according to healthcare coverage types and its associated factors. J Korea Acad Industr Soc 2015;16(6):4067-4076 (Korean).
  9. Kim MJ, Kam S, Lee WK. Inequality status of household medical expenditure distribution by household income quartile and associated factors with household catastrophic medical expenditure in Korea. J Health Info Stat 2017;42(3):232-240 (Korean). https://doi.org/10.21032/jhis.2017.42.3.232
  10. The Ministry of Health and Welfare. 2014-2018 Plan for benefit enhancement on National Health Insurance. Sejong: Ministry of Health and Welfare; 2015 (Korean).
  11. Kim Y. Towards universal coverage: an evaluation of the benefit enhancement plan for four major conditions in Korean National Health Insurance. J Korean Med Asso 2014;57(3):198-203 (Korean). https://doi.org/10.5124/jkma.2014.57.3.198
  12. Van Doorslaer E, Wagstaff A. Measuring and testing for inequity in the delivery of health care. J Hum Resour 2000;35(4):716-733. https://doi.org/10.2307/146369
  13. Kwon SM, Yang BM, Lee TJ, Oh JW, Lee SH. Equity in health care utilization in Korea. Korean J Health Econ Policy 2003;9(2):13-24 (Korean).
  14. Lim SJ, Kim SH, Choi EH. Study on impact analysis and policy plan of system development about co-payment upper limit. Wonju: National Health Insurance Service; 2015, p. 17-20 (Korean).
  15. Kim DY. Analysis of changes to equality in health and medical service utilization by income levels. J Soc Sci 2012;23(2):105-125 (Korean).
  16. Yoon YJ. Trend of horizontal equity in health care utilization and incidence of household catastrophic health expenditure [dissertation]. Graduate School of Public Health, Seoul National University; Korea, 2012.
  17. Seo NK, Kang TW, Her SL, Lee HJ, Kim DS, Lim BM, et al. 2008-2014 Korea health system based on healthcare indicators: 2016 in-depth analysis report on Korea Health Panel. Wonju: National Health Insurance Service; 2016, p. 149-162 (Korean).
  18. Yang DW, Kim HL, Kang ES, Kim DE, Bae EY, Kim JH. Patterns and determinants of catastrophic health expenditure in the households with cancer patients. Korean J Health Econ Policy 2017;23(1):53-70 (Korean).