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The temporal association of excessive health expenditure with suicidal ideation among primary income earners: a cross-sectional design using the Korean Welfare Panel Survey (KoWePS)

 Jaeyong Shin  ;  Jae Woo Choi  ;  Sung-in Jang  ;  Young Choi  ;  Sang Gyu Lee  ;  Tae Hwan Ihm  ;  Eun-Cheol Park 
 BMJ OPEN, Vol.5(6) : 007421, 2015 
Journal Title
Issue Date
Adult ; Aged ; Cost of Illness ; Cross-Sectional Studies ; Depressive Disorder/economics ; Depressive Disorder/psychology ; Female ; Health Expenditures* ; Humans ; Income ; Male ; Middle Aged ; Multivariate Analysis ; Republic of Korea ; Suicidal Ideation*
economic burden ; health expenditure ; household ; korea ; suicidal ideation ; suicide
OBJECTIVE: Excessive health expenditure (EHE) is a global issue for households suffering from high-cost medical conditions, low incomes and limited insurance coverage. After the international financial crisis of 2008, EHE became a social problem in developed countries. Such economic crisis might induce severe mental stress, resulting in suicidal ideation.

METHODS: We used the Korean Welfare Panel Study (KoWePS) from 2011 to 2013 and selected primary income earners, who were defined as practical and economic representatives of households; the total number of analysed samples was 4247 of 5717 households in the database. We only included households that had never experienced EHE before 2011. To examine the temporal relationship between EHE and suicidal ideation, we conducted a logistic regression analysis.

RESULTS: Among 4247 participants, 146 (3.4%) experienced suicidal ideation, whereas 4101 (96.6%) did not. One scale of depression score (OR=1.28, CI 1.23 to 1.34, p<0.001) was associated with increased suicidal ideation. Such ideation was influenced to a greater extent by a recent EHE above 10% of disposable income (OR=1.91, CI 1.16 to 3.15, p=0.012) than by either a remote EHE (OR=1.29, CI 0.71 to 2.32) or one in 2011 and 2012 (OR=1.67, CI 1.01 to 2.78, p=0.048).

CONCLUSIONS: In this study, more recent EHE resulted in more suicidal ideation. In conclusion, we suggest that recent household EHE might be considered as an important factor to prevent suicidal ideation and to improve the mental health of individuals.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Shin, Jae Yong(신재용) ORCID logo https://orcid.org/0000-0002-2955-6382
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
Choi, Jae Woo(최재우)
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