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Paying out-of-pocket for health care in Korea: Changes in catastrophic and poverty impact over a decade of 1996-2005

보건학논집 - 서울대학교 2017년 54권 1호 p.31 ~ 41
이태진,
소속 상세정보
이태진 ( Lee Tae-Jin ) - Seoul National University Graduate School of Public Health

Abstract


Objectives: Despite the existence of a national health insurance system, out-of-pocket (OOP) payments have been playing an important role in the financing of health care in Korea. Using the data from a nationally representative household expenditure survey, this study aims to examine the trend in the catastrophic and impoverishing impact of OOP payments in Korea over the decade from 1996 to 2005. It also investigates the catastrophic impact by income quintiles and by type of service.

Methods: The catastrophic payment headcount is measured as the percentage of households spending OOP payments in excess of 10% of total household expenditures. The poverty headcount is measured by comparing the proportion of individuals who fall below the poverty line before and after OOP payments are deducted from household resources. The national poverty line is used as a poverty threshold.

Results: The percentage of households with OOP payments in excess of the 10% threshold was 11.8% in 1996, went down to 10.2% in 2001, and increased again to 11.8% in 2005. The catastrophic impact has been greatest and has increased among the poorest 20% of households since 2001. The poor are more likely to incur catastrophic payments on drug and outpatient care while the better-off are more likely to spend in excess of the thresholds on inpatient and dental care. The impoverishing effect of OOP payments, though moderate, has been enlarged gradually in recent years.

Conclusion: It is necessary not only to reduce overall OOP payments by extending insurance coverage particularly for inpatient care, but also to ease the vulnerable households’ financial burden by exempting them from some OOP payments.

키워드

National health insurance; out-of-pocket payments; catastrophic impact; poverty impact

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