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KMID : 1170320230290020141
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Korean Journal of Health Economics and Policy
2023 Volume.29 No. 2 p.141 ~ p.171
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Catastrophic health expenditure and impoverishing health spending analysis using Korean National Health Insurance Service data
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Lee Young-Sil
Seo Eun-Sol
Lee Tae-Jin
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Abstract
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Backgrounds: Until now, the calculation of financial protection indicators related to healthcare expenditures in Korea has been mainly conducted using panel survey data, which has deviated from the data actually available by the Korean National Health Insurance Service (NHIS), the main body of the catastrophic health expenditure (CHE) support program. This study calculated the incidence of CHE and impoverishing health spending (IHS) using the claims data to show the possibility of regular monitoring by the NHIS.
Methods: Analyses were conducted using data from 2018 to 2020. The incidence of CHE and IHS were calculated by year and by disease, and the number and type of households with new CHE and IHS were calculated. Finally, we tried to explore high-risk groups that require intensive monitoring through logistic regression analysis.
Results: The incidence of CHE using NHIS data was 16.7% in 2018, 17.0% in 2019, and 16.6% in 2020. The incidence of IHS was 2.75% in 2018, 2.82% in 2019, and 2.78% in 2020. Households with severe diseases had twice the incidence of CHE and IHS compared to households without severe diseases. After COVID-19, the number of new CHE cases decreased, but the number of new IHS cases increased. The ‘income reduction type’ increased, and the ‘healthcare expenditure increase type’ decreased.
Conclusion: The calculation of CHE and IHS incidence using NHIS claims data has limitations, but it was not different much from previous studies, suggesting its validity as a data source for calculating financial protection indicators.
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KEYWORD
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Catastrophic Health Expenditure, Impoverishing Health Spending, Claims Data
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