Health care utilization and costs among medical-aid enrollees, the poor not enrolled in medical-aid, and the near poor in South Korea

Choi, Jae Woo; Park, Sohee; Chun, Sang Sik; Han, Kyu Tae; Han, Euna; Kim, Tae Hyun

doi:10.1186/s12939-015-0257-9

Cited by 41 publications

(47 citation statements)

References 24 publications

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“…At least for low-income households, it appears that Medical Aid contributes more financial protection than alternative insurance programmes. 34 In contrast, households with elderly people and those containing individuals with a disability had significantly higher odds of experiencing CHE, similar to previous studies. 35 36 This study has a few limitations.…”

Section: Discussionsupporting

confidence: 88%

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

et al. 2016

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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.

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Section: Discussionsupporting

confidence: 88%

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

et al. 2016

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“…As a proxy for household income, this study assessed poverty based on the average annual insurance premium, which was available in deciles. National health insurance in South Korea is universal and compulsory and offers three types of coverage: community insurance (for self‐employed individuals), workplace health insurance (for employees), and medical aid, which is a public medical assistance program provided to the poor via the South Korean National Basic Livelihood Security System . In 2013, 29.1% of Koreans were enrolled in community insurance, 68.0% in workplace insurance, and 2.9% in medical aid .…”

Section: Methodsmentioning

confidence: 99%

Poverty and suicide risk in older adults: A retrospective longitudinal cohort study

Choi

Kim

Shin

et al. 2019

Int J Geriat Psychiatry

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Objectives The present study evaluated suicide risk within 1 year after discharge among older adults with stroke as a function of depression onset. Method We used the Korean National Health Insurance Service‐Senior cohort data and included first discharged patients with a stroke as the principal diagnosis. The comparison group was selected by a 1:2 case‐control propensity score matching for age, sex, Charlson comorbidity index, and diagnosis year between 2005 and 2012. Suicide deaths were measured by code for causes of death from Statistics Korea, and the main outcome was suicide death within 1 year following discharge. An adjusted hazard ratio (AHR) of suicidal risk was measured using a Cox proportional hazard model. Results In the total sample of 128 286 older adults (aged 63‐114 years), the higher suicidal risk was examined for stroke patients vs the comparison group (AHR = 1.4; 95% confidence interval [CI], 1.1‐1.8). Stroke patients with depression had an increased suicide risk (AHR = 2.9; 95% CI, 1.8‐4.8) but only for poststroke depression (AHR = 4.1; 95% CI, 1.8‐9.5). Pre and poststroke depression suicidality (AHR = 4.8; 95% CI, 2.1‐11.1) was also higher when compared to stroke patients without depression. Conclusions Poststroke patients are at increased suicidal risk during 1 year following discharge. Furthermore, patients who were diagnosed with depression after a stroke are more likely to commit suicide than stroke patients without depression. This suggests a necessity for early suicide preventive intervention for stroke patients while considering depressive symptomology.

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“…The beneficiaries are supported by seven kinds of benefits, including Medical-Aid [13]. Medical-aid had 1,507,044 beneficiaries, representing 3.0 % of the country’s population, in 2012 and Medical-Aid provides assistance to the poor with almost-free medical services [14]. The Korean Medical-Aid program is comparable to the US “Medicaid” program, which was established in 1965, and provided healthcare services to approximately 58 million people in 2011, including low-income families, seniors, disabled, and pregnant women [15].…”

Section: Introductionmentioning

confidence: 99%

“…Even if their income level is below 100 % of the poverty line, which is the minimum cost of living, they are excluded when the value of their property is above a certain threshold, or the income property of their support obligor is over a certain level [14]. Minimum cost of living is the minimum expense to sustain one’s life.…”

Section: Introductionmentioning

confidence: 99%

Medical security and catastrophic health expenditures among households containing persons with disabilities in Korea: a longitudinal population-based study

Choi

Shin

Cho

et al. 2016

Int J Equity Health

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BackgroundAlthough persons with disabilities need access to comprehensive and consistent healthcare services, a significant number of the poor with disabilities do not receive Medical-Aid due to the conditions of eligibility. We aimed to compare the financial burden of healthcare services between two groups of poor persons with disabilities: those not enrolled in Medical-Aid and Medical-Aid enrollees.MethodsThis study used the 1st–8th data (2008–2014 year) of Panel Survey of Employment for the Disabled (PSED) conducted by the Korea Employment Agency for the Disabled. We classified adults who did not exceed 100 % of the poverty level into two groups (N = 3,010). The first group consisted of enrollees in Medical-Aid (n = 1,259) and the second group comprised those not enrolled in Medical-Aid (n = 1,325). We applied generalized estimating equations (GEEs) to assess the independent effect of enrollment in Medical-Aid on catastrophic health expenditures (CHE).ResultsWe found that about 4.2 % of the poor not enrolled in the Medical-Aid experienced CHE and the poor not enrolled in Medical-Aid were 2.1 times more likely to experience CHE than Medical-Aid enrollees after applying multivariate models adjusted for several covariates.ConclusionsGiven the additional expenses for treatment and rehabilitation caused by disability-related health problems, persons with disabilities are more likely to face barriers to needed medical services. Thus, policy makers need to expand the number of people receiving Medical-Aid by loosening the strict criteria for those with disabilities.

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Health care utilization and costs among medical-aid enrollees, the poor not enrolled in medical-aid, and the near poor in South Korea

Cited by 41 publications

References 24 publications

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

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

Poverty and suicide risk in older adults: A retrospective longitudinal cohort study

Medical security and catastrophic health expenditures among households containing persons with disabilities in Korea: a longitudinal population-based study

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