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The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching

 Jae Woo Choi  ;  Eun Cheol Park  ;  Ki Bong Yoo  ;  Sang Gyu Lee  ;  Sung In Jang  ;  Tae Hyun Kim 
 BMC Health Services Research, Vol.15 : 369, 2015 
Journal Title
 BMC Health Services Research 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Financing, Personal/economics* ; Financing, Personal/statistics & numerical data* ; Health Expenditures/statistics & numerical data* ; Humans ; Income/statistics & numerical data* ; Longitudinal Studies ; Male ; Middle Aged ; National Health Programs/economics* ; Propensity Score ; Republic of Korea ; Socioeconomic Factors
Propensity Score Match ; Medical Expenditure ; Private Health Insurance ; Medical Expense ; High Medical Cost
BACKGROUND: Almost 97% of the Korean population is covered by National Health Insurance and are entitled to receive the same level of insurance benefits, regardless of how much each enrollee contributes to the system. However, the percentage of out-of-pocket payments is still high. This study examines whether the incurrence of high medical expenses affects household income. METHODS: We use the Korea Welfare Panel and select 4,962 households to measure repeatedly over 5 years. Using propensity score matching, we set households with medical expenses of three times the annual average as "occurrence households" while "non-occurrence households" are those below the cut-off but with all other factors, such as income, held constant. We analyze whether the income of occurrence households differs significantly from the comparison group using a linear mixed effect model. RESULTS: After the occurrence of high medical expenditure, occurrence households (n = 825) had US$ 1,737 less income than non-occurrence households. In addition, the income of households (n = 200) that incurred high medical costs repeatedly for 2 years was US$ 3,598 lower than the non-occurrence group. CONCLUSIONS: Although it is important for the government to focus on medical assistance for households that have medical expense burdens, it needs to consider providing income indemnity insurance to protect them.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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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