Out-of-Pocket Healthcare Spending by the Poor and Chronically Ill in the Republic of Korea

Jennifer Prah Ruger · Hak‐Ju Kim

105 citations0/0 files storedAmerican Journal of Public Health

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Abstract

OBJECTIVES: We estimated out-of-pocket health care spending and out-of-pocket spending burden ratio employing household equivalent income in the Republic of Korea. We examined variations in out-of-pocket spending, estimated out-of-pocket spending burden ratio employing household equivalent income, and identified factors associated with out-of-pocket spending. METHODS: We used the 1998 Korean National Health and Nutrition Survey, a nationally representative survey of 39,060 individuals. Our analyses examined out-of-pocket spending, out-of-pocket spending burden ratio, and health care use by socioeconomic status, insurance type, health care facility type, and chronic condition after we controlled for sociodemographic variables. RESULTS: The lowest income quintile spent 12.5% of their total income out-of-pocket on medical expenditures, which was 6 times that of the highest income quintile (2%). Among those with 3 or more chronic conditions, low-income Koreans had the highest out-of-pocket spending burden ratio (20%), which was 5 times the spending burden among high-income Koreans (4%). In multivariate analyses, the number of chronic conditions, insurance type, health care use, and health care facility type were associated with out-of-pocket spending. CONCLUSIONS: Out-of-pocket spending in Korea is regressive, because lower-income groups pay disproportionately more of their income compared with higher-income groups. Low-income individuals with multiple chronic conditions are particularly vulnerable.

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2003Household catastrophic health expenditure: a multicountry analysis 1995Income distribution in OECD countries: evidence from the Luxembourg Income Study 2001Out-Of-Pocket Medical Spending For Care Of Chronic Conditions 2004Making health systems more equitable

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