Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
Int J Equity Health. 2018 Nov 14;17(1):166. doi: 10.1186/s12939-018-0883-0.
The objective of our study was to investigate the relationship between catastrophic health expenditure (CHE) and health-related quality of life (HRQoL) in general population.
We used Korean Health Panel Survey data from 2011 to 2013, which included data from 8850 baseline participants of 19 years of age or older. We defined CHE as total annual out-of-pocket health payment that was 40% greater than the household's capacity to pay. HRQoL was measured using the EuroQol-visual analogue scale (EQ-VAS). We used generalized estimating equations to perform a longitudinal regression analysis.
A total of 4.5% of the participants (n = 398) experienced CHE. Those with CHE tended to have a lower EQ-VAS index score compared with those without CHE (β: - 1.34, p = 0.013). A subgroup analysis revealed that individuals experiencing CHE had significant decreases as the number of chronic diseases increased (three or more, β: - 1.85, p = 0.014).
Catastrophic health expenditure influences HRQoL, which was more pronounced in patient with chronic disease. The efforts should focus on people who suffer from excessive health expenditures and chronic diseases.
本研究旨在探讨一般人群中灾难性卫生支出（CHE）与健康相关生活质量（HRQoL）之间的关系。
我们使用了 2011 年至 2013 年的韩国健康面板调查数据，其中包括了 8850 名年龄在 19 岁及以上的基线参与者的数据。我们将 CHE 定义为总年度自付医疗费用超过家庭支付能力的 40%。HRQoL 使用欧洲五维健康量表视觉模拟评分（EQ-VAS）进行衡量。我们使用广义估计方程进行纵向回归分析。
共有 4.5%的参与者（n=398）经历了 CHE。与没有 CHE 的人相比，有 CHE 的人 EQ-VAS 指数得分往往较低（β：-1.34，p=0.013）。亚组分析显示，随着慢性病数量的增加，经历 CHE 的个体的 EQ-VAS 得分显著下降（三种或更多，β：-1.85，p=0.014）。
灾难性卫生支出影响 HRQoL，在患有慢性病的患者中更为明显。应关注那些遭受过度卫生支出和慢性病困扰的人群。
