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Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016.

ABSTRACT: Background:The rate of catastrophic health expenditure (CHE) continues to rise in South Korea. This study examined the association between changes in economic activity and CHE experiences in South Korea. Methods:This study analyzed the Korea Health Panel Survey data using a logistic regression analysis to study the association between changes in economic activity in 2014-2015 and the participants' CHE experiences in 2015. The study included a total of 12,454 individuals over the age of 19. The subgroup analyses were organized by sex, age, health-related variables, and household level variables, and the reasons for leaving economic activity. Results:Those who quit economic activities were more likely to experience CHE than those who continued to engage in economic activities (OR [odds ratio]?=?2.10; 95% CI [confidence interval]: 1.31-3.36). The subgroup analysis results, according to health-related variables, showed that there is a tendency to a higher Charlson comorbidity index, a higher OR, and, in groups that quit their economic activities, people with disabilities were more likely to experience CHE than people without disabilities (OR?=?5.63; 95% CI 1.71-18.59, OR?=?1.82; 95% CI 1.08-3.08, respectively). Another subgroup analysis found that if the reason for not participating in economic activity was a health-related issue, the participant was more likely to experience CHE (active???inactive: OR?=?2.40; 95% CI 0.61-9.43, inactive???inactive OR?=?1.65; 95% CI 1.01-2.68). Conclusions:Those individuals who became unemployed were more likely to experience CHE, especially if health problems precipitated the job loss. Therefore, efforts are needed to expand coverage for those people who suffer from high medical expenses.

SUBMITTER: Lee HJ

PROVIDER: S-EPMC7493960 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016.

Lee Hyeon Ji HJ Lee Doo Woong DW Choi Dong-Woo DW Oh Sarah Soyeon SS Kwon Junhyun J Park Eun-Cheol EC

Cost effectiveness and resource allocation : C/E 20200916

<h4>Background</h4>The rate of catastrophic health expenditure (CHE) continues to rise in South Korea. This study examined the association between changes in economic activity and CHE experiences in South Korea.<h4>Methods</h4>This study analyzed the Korea Health Panel Survey data using a logistic regression analysis to study the association between changes in economic activity in 2014-2015 and the participants' CHE experiences in 2015. The study included a total of 12,454 individuals over the a ...[more]

PMID: 32973406

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Project description:BackgroundFinancial protection is a key dimension of universal health coverage. Catastrophic health expenditure (CHE) has increased in India over time. The overall figures mask the subnational heterogeneity crucial for designing insurance coverage for 1.3 billion population across India. We estimated CHE in every state of India and the changes over a decade.MethodsWe used National Sample Survey data on health care utilisation in 2004 and 2014. The states were placed in four groups based on epidemiological transition level (ETL), defined on the basis of ratio of disability-adjusted life-years from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL state group. CHE was defined as the proportion of households that had out-of-pocket payments for health care equalling or exceeding 10% of the household expenditure. We assessed variation in the magnitude and distribution of CHE between ETL state groups and between states of India.ResultsIn 2014, CHE was higher in the high (30.3%, 95% confidence interval: 28.5 to 32.1) and higher-middle (27.4%, 26.3 to 28.6) ETL state groups than the low (21.8%, 20.8 to 22.8) and lower-middle (19.0%, 17.1 to 21.0) groups. From 2004 to 2014, CHE increased only in the high and higher-middle ETL groups (1.19 and 1.34 times, respectively). However, the individual states with substantial increase in CHE were spread across all ETL groups. The gap between the highest CHE of an individual state and the lowest was 8-fold in 2014. CHE was disproportionately concentrated among the rich in 2004 for most of India, but in 2014 CHE was distributed equally among the rich and poor because of the substantial increase in CHE among the poor over time.ConclusionsBetter provision of quality health care should be accompanied by financial protection measures to safeguard the poor from increasing CHE in India. The state-specific CHE trends can provide useful input for the planning of the recently launched National Health Protection Mission such that it meets the requirement of each state.

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Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016.

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Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016.

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