• Health Policy and Management
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• v.33 no.2
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• pp.166-172
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• 2023

Background: To improve the support low-income individuals' medical expenses, it is necessary to think about ways to enhance the Catastrophic Health Expenditure Support Program. This study proposes expanding support criteria and changing the income standard. Methods: This study conducted simulations using national data from the National Health Insurance Service. Simulations performed for people who have used health services (n=172,764) in 2022 to confirm the Catastrophic Health Expenditure Support Program's size based on changes to the subject selection criteria. Results: As a result of the simulation with expanded criteria, the expected budget was estimated to increase between Korean won (KRW) 13.2 (11.5%) and 138.6 billion (37.4%), and the number of recipients increased between 41,979 (48.9%) and 150,317 (76.1%). The results of the simulation for the change in income criteria (applied to health insurance levels below the 50th percentile) estimated the expected budget to increase between KRW -8.9 (-7.8%) and 55.6 billion (15.0%) and the number of recipients to increase between -8,704 (-10.1%) and 41,693 (21.1%) compared to the current standard. Conclusion: The 2023 Catastrophic Health Expenditure Support Program's criteria were expanded as per the 20th Presidential Office's national agenda to alleviate the burden of medical expenses on the low-income class. In addition, The Catastrophic Health Expenditure Support Program needs to be integrated with other medical expense support policies in the mid- to long-term, and a foundation must be prepared to ensure the consistency of each system.

• Health Policy and Management
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• v.33 no.4
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• pp.400-410
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• 2023

Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.

• Health Policy and Management
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• v.34 no.3
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• pp.319-333
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• 2024

Background: This study aims to identify the factors that influence the incidence of catastrophic health expenditure (CHE) for the elderly living alone and to discuss how to manage CHE for the elderly living alone. Methods: This study utilizes 6th (2016), 7th (2018), and 8th (2020) data from the Korean Longitudinal Study of Aging to identify the incidence rate of CHE among the elderly living alone and conducts a panel logit analysis. The dependent variable is the incidence of CHE (thresholds: 10%, 20%, 30%), and the independent variables include demographic factors (gender, age group, region), socioeconomic factors (education level, economic activity status, income quintile, financial support rate from children), health-related factors (subjective health status, regular exercise, smoking, drinking, number of chronic diseases), and healthcare coverage factors (type of health insurance, private health insurance). Results: Descriptive statistics classified by gender show that female elderly living alone are more vulnerable than male elderly living alone in terms of disease prevalence and socioeconomic status. In addition, the incidence of CHE is higher for elderly women living alone than for elderly men living alone across all thresholds. The main results of the panel logit analysis show that higher education, income quintile, and financial support rate from children are associated with lower odds of CHE, while poorer subjective health and a higher number of chronic diseases are associated with higher odds of CHE. Medical aid recipients are less likely to incur CHE than those covered by national health insurance. Conclusion: The implications of this study are as follows. First, vulnerable elderly living alone with multiple chronic diseases and low income and education levels are more likely to incur CHE. Second, it is necessary to review policies such as a CHE support program and chronic disease management programs focused on vulnerable elderly individuals living alone. Third, the CHE support program should be operated in a patient-centered manner, with consideration given to a customized system for selecting and supporting elderly individuals living alone who are in need.