Catastrophic health expenditures for households with multiple chronic conditions in Korea Health Panel 2011 and 2012

Multiple chronic conditions;Multimorbidity;복합만성질환;재난적의료비;과부담의료비;Catastrophic health expenditures;Office of the Assistant secretary of Health;OASH;614

Heejung Choi보건대학원 보건학과 ;

University:서울대학교 보건대학원

关键词: Multiple chronic conditions;    Multimorbidity;    복합만성질환;    재난적의료비;    과부담의료비;    Catastrophic health expenditures;    Office of the Assistant secretary of Health;    OASH;    614;   

Others  :  http://s-space.snu.ac.kr/bitstream/10371/128403/1/000000133474.pdf

美国|英语

来源: Seoul National University Open Repository

【 摘 要 】

BackgroundsThe simultaneous presence of multiple conditions in one patient (multiple chronic conditions, MCC) is a key challenge facing healthcare systems globally(Violan et al. 2014). With population aging, prevalence of MCC increases. Measurement MCC capacities has been constrained by lack of consistency in definitions and diagnostic classification schemes(Goodman et al. 2013). In addition, the management of MCC is associated with potentially severe economic consequences. There are too many previous researches to measure catastrophic health expenditures (CHE), but it is hard to find out the one measured CHE for MCC group in spite of the great medical expenditure burden of multiple chronic conditions (MCC). Subject and MethodThis study used and analyzed the data from the KHP 2011 with a total 5654 households and the KHP 2012 with a total 5378 households. This study focused on multiple condition groups who were defined as a 20yr old or over household member with at least two chronic conditions and the condition last one year or more.This study measured CHE according to the proportion of out-of-pocket health expenditure to non-food household expenditures reported by Wagstaff et al. This study calculated CHE with 25% and 40% catastrophic threshold and those figures were made a comparison each other with entire KHP households, chronic condition group, MCC group. Then, associated factors of CHE were estimated using ordinary least square and logistic regression modeling. ResultsHousehold with more member of multiple chronic conditions (MCC) retention faced more catastrophic health expenditures (CHE).According to the CHE threshold 40%, catastrophic health expenditures occurred, 3.69% in 2011, 4.32% in 2012 at non MCC group, 9.45% in 2011 9.95% in 2012 at 1 MCC group, 22.02% in 2011, 15.74% in 2012 at 2 MCC group, and 0% in 2011 and 2012 at 3 MCC group. Except 3 MCC group, the number of MCC members in a household was proportional to the incidence of catastrophic health expenditures. As in the CHE threshold 25%, catastrophic health expenditures took place 8.89% in 2011, 7.88% in 2012 at non MCC group, 19.02% in 2011, 19.77% in 2012 at 1 MCC group, 33.93% in 2011, 30.86% in 2012 at 2 MCC group, and50% in 2011, 0% in 2012 at 3 MCC group. Regardless of catastrophic thresholds, ;;chronic kidney disease’, ;;cardiac arrhythmias’, ;;cancer’, ;;osteoporosis’, ;;diabetes’, ;;arthritis’ significantly affected to the incidence of CHE.ConclusionThis study found that, even though there are some cases with too small number of CHE likewise in the 3 MCC group, there were trend that the more a household has MCC member in a household, the bigger there were CHE incidence. However, with regard to the intensity of CHE, there was not evident trend with the number of MCC member in a household.