Catastrophic health expenditure according to employment status in South Korea: a population-based panel study

Abstract

ObjectivesCatastrophic health expenditure (CHE) means that the medical spending of a household exceeds a certain level of capacity to pay. Previous studies of CHE have focused on benefits supported by the public sector or high medical cost incurred by treating diseases in South Korea. This study examines variance of CHE in these households according to changes in employment status. We also determine whether a relationship exists according to income level.DesignA longitudinal study.SettingWe used the Korean Welfare Panel Study (KOWEPS) conducted by the Korea Institute.ParticipantsThe data came from 5335 households during 2009–2012.Outcome measureCHE, defined as health expenditures that were 40% greater than the ability of the household to pay.ResultsHouseholds with people who experienced changes in job status from employed to unemployed (OR 2.79, 95% CI 2.06 to 3.78) or were unemployed with no status change (OR 1.57, 95% CI 1.28 to 1.92) were more likely to incur CHE than those containing people who were consistently employed. In addition, low-income families with members who had either lost a job (OR 3.52, 95% CI 2.44 to 5.10) or were already unemployed (OR 1.67, 95% CI 1.29 to 2.16) were more likely to incur CHE than those with family members with a consistent job.ConclusionsGiven the insecure employment status of people with low income, they are more likely to face barriers in obtaining needed health services. Meeting their healthcare needs is an important consideration.

A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

“…We identified several determinants of CHE in this review, but it is worthy to note that household poverty/low socio‐economic status was the most common factor that increased CHE in six out of the eight studies that assessed determinants of CHE. Similarly, poverty has also been recognized as a determinant of CHE in other studies . This is especially so given that even small costs for common illnesses can be financially disastrous for poor households with no insurance cover .…”

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

“…On the other hand, two studies found that having insurance was a risk factor for incurring CHE (33, 44). Four studies reported that insurance does not have a significant effect on the occurrence of CHE (33, 35, 43, 46). Two of the studies on the situation in China both reported that the role of insurance depends on the type of insurance scheme that the household has; urban health insurance was found to be protective whereas rural health insurance was found to be a positive predictor that increases the risk of experiencing CHE (22, 39).…”

“…A total of 25 studies investigated the relationship between family size and incurring CHE ( 15 , 16 , 18 – 22 , 24 – 28 , 31 – 43 ). Five studies found that the relationship is not significant ( 16 , 19 , 36 , 38 , 41 ), ten studies found that a large family size is a risk factor ( 18 , 20 , 22 , 24 , 26 , 31 , 32 , 34 , 35 , 40 ) and ten found that a small family size is associated with a higher risk ( 15 , 21 , 25 , 27 , 28 , 33 , 37 , 39 , 42 , 43 ).…”

“…The gender of the head of household was found to be a non-significant factor in 16 papers out of the 27 that analysed this factor ( 15 , 16 , 18 – 20 , 24 , 25 , 30 – 32 , 34 , 36 , 37 , 40 , 42 , 45 ). However, in the remaining 11 studies, a female head of household is identified as a risk factor ( 17 , 21 , 23 , 26 – 29 , 39 , 41 , 43 , 44 ). In Uganda, this variable was found to be a risk factor among the non-poor, but not significant among the poor ( 17 ).…”

Catastrophic Household Expenditure for Healthcare in Turkey: Clustering Analysis of Categorical Data

“…On the other hand, Yang et al [9] found that catastrophic health expenditures have a high incidence among elderly households in China, and empty-nest households are at a higher risk for catastrophic health expenditures than non-empty-nest households. Moreover, Choi et al [10] found that for South Korea by using panel data low-income families with members who had either lost a job or were already unemployed are more likely to incur catastrophic health expenditure than those with family members with a consistent job.…”