National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, South Korea.
Health Policy. 2011 May;100(2-3):239-46. doi: 10.1016/j.healthpol.2010.08.008. Epub 2010 Sep 15.
The compositions of health expenditures by households in South Korea with and without catastrophic health expenditures were compared. Also, relationships between catastrophic health expenditures and household incomes, and between such health expenditures and expenditure patterns were explored.
Data from the 2006 South Korean Household Income & Expenditure Survey, a representative survey of 90,696 households were analyzed. We used a double-hurdle model to assess each income source and expenditure category. The independent variable was the presence of catastrophic health expenditure.
After adjusting for household characteristics, the results showed that earned, business, and property incomes were significantly lower, but transfer and loan incomes were significantly higher in households with catastrophic health expenditures than in those without such health expenditures. All consumption categories, other than health expenditure, were significantly lower in households with catastrophic health expenditures than in those without catastrophic health expenditures. This suggests that households with catastrophic health expenditures faced challenges in offset by the potentially excessive health expenditure and may have been obliged to reduce consumption of other items.
The expansion of insurance coverage and lowering of out-of-pocket rates in the South Korean Health Insurance benefits could be a necessary first step in protecting households from the occurrence of health related economic catastrophes.
比较韩国有和无灾难性卫生支出家庭的卫生支出构成。还探讨了灾难性卫生支出与家庭收入之间的关系,以及这些卫生支出与支出模式之间的关系。
对代表 90696 户家庭的 2006 年韩国家庭收入和支出调查的数据进行了分析。我们使用双门槛模型评估每个收入来源和支出类别。自变量是灾难性卫生支出的存在。
调整家庭特征后,结果表明,有灾难性卫生支出的家庭的劳动、商业和财产收入明显较低,但转移和贷款收入明显较高。有灾难性卫生支出的家庭的所有消费类别,除了卫生支出,都明显低于没有灾难性卫生支出的家庭。这表明,有灾难性卫生支出的家庭在应对潜在过度卫生支出方面面临挑战,可能不得不减少其他项目的消费。
扩大韩国健康保险福利的保险覆盖范围和降低自付费用率可能是保护家庭免受与健康相关的经济灾难发生的必要的第一步。