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

Authors
 Jae Woo Choi  ;  Tae Hyun Kim  ;  Sung In Jang  ;  Suk Yong Jang  ;  Woo-Rim Kim  ;  Eun Cheol Park 
Citation
 BMJ OPEN, Vol.6(7) : 011474, 2016 
Journal Title
 BMJ OPEN 
Issue Date
2016
MeSH
Acute Disease/economics* ; Acute Disease/epidemiology ; Acute Disease/therapy ; Adult ; Chronic Disease/economics* ; Chronic Disease/epidemiology ; Chronic Disease/therapy ; Cost of Illness ; Delivery of Health Care/economics* ; Employment/statistics & numerical data* ; Family Characteristics ; Female ; Financing, Personal/economics* ; Health Expenditures/statistics & numerical data* ; Humans ; Longitudinal Studies ; Male ; Republic of Korea/epidemiology ; Socioeconomic Factors
Keywords
Catastrophic Health Expenditure ; Changes in Employment Status ; Income Level
Abstract
OBJECTIVES: Catastrophic 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. DESIGN: A longitudinal study. SETTING: We used the Korean Welfare Panel Study (KOWEPS) conducted by the Korea Institute. PARTICIPANTS: The data came from 5335 households during 2009-2012. OUTCOME MEASURE: CHE, defined as health expenditures that were 40% greater than the ability of the household to pay. RESULTS: Households 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. CONCLUSIONS: Given 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
DOI
10.1136/bmjopen-2016-011747
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 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
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151669
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