期刊论文详细信息
BMC Health Services Research
Medical service utilization and out-of-pocket spending among near-poor National Health Insurance members in South Korea
Sooyeol Park1 
[1] Division of Health Care Management and Policy, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 08826, Seoul, Republic of Korea;Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, 21218, Baltimore, MD, USA;
关键词: Medical utilization;    Out-of-pocket spending;    Catastrophic health expenditure;    Poverty;    Relative poverty;   
DOI  :  10.1186/s12913-021-06881-8
来源: Springer
PDF
【 摘 要 】

BackgroundThe public health care system in South Korea is a two-tiered system. The lowest-income population is covered by the Medical Aid program, and the remaining population is covered by the National Health Insurance. The near poor, a relatively low-income population which is excluded from South Korea’s Medical Aid program due to exceeding the income threshold, experiences insufficient use of medical services and incurs high out-of-pocket expenses due to a lack of coverage under the country’s National Health Insurance (NHI) program. This study aims to examine medical utilization, out-of-pocket spending, and the occurrence of catastrophic health expenditures among the near-poor group compared to both Medical Aid beneficiaries and other (higher income) NHI members.MethodsA cross-sectional study was conducted drawing upon a nationally representative dataset derived from the 2018 Korea Welfare Panel Study. The study classified people into three groups: Medical Aid beneficiaries; the near-poor population below 50 % of the median income threshold but still not qualifying for Medical Aid and thus enrolled in NHI; and NHI members above the threshold of 50 % of the median income. Using a generalized boosted model to estimate the propensity score weights between study groups, this study examined medical utilization, out-of-pocket spending, and the occurrence of catastrophic health expenditure among the study groups.ResultsThe findings suggest that the utilization of medical services was not significantly different among the study groups. However, out-of-pocket spending and the occurrence of catastrophic health expenditure were significantly higher in the near-poor group compared to the other two groups.ConclusionsThe study found that the near-poor group was the most vulnerable among the Korean population because of their higher chance of incurring greater out-of-pocket spending and catastrophic health expenditures than is the case among the Medical Aid beneficiary and above-poverty line groups. Health policy needs to take the vulnerability of this near-poor population into account.

【 授权许可】

CC BY   

【 预 览 】
附件列表
Files Size Format View
RO202109171020869ZK.pdf 610KB PDF download
  文献评价指标  
  下载次数:7次 浏览次数:2次