• 가정과삶의질연구
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• 제28권1호
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• pp.159-174
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• 2010

The purpose of this study was to examine the health care expenditure of elderly single and elderly couple households whose head is more than 60 years old. The data analyzed for the study were Korean Retirement and Income Study(KRelS) conducted in 2007 by National Pension Corporation. The major finding of this study were as follows: First, the amount of health care expenditure of elderly single households was lower than that of elderly couple households. However, ratio of health care expenditure to total consumption expenditure of elderly single households was larger than that of elderly couple households. Second, the ratio of health care expenditure in consumption expenditure in this study was larger than the ratios in past analyse showed in the previous studies. Third, common factor affecting on health care expenditure of elderly single and elderly couple households was the existence of the family member with chronic disease or handicap. The health care expenditure of elderly singer households was influenced by income, gender and the ownership of national health insurance. The influence of income for elderly singer households seemed to be greater than for elderly couple households. The variables which affected health care expenditure of elderly couple households were age and housing tenure status. The amount and ratio health care expenditure were increased as the age increases. These results show that the health care expenditures for each groups varied according to socio-demographic variables and health-related behavior variables. It is suggested that there should be a discriminative health care policy for each elderly single and elderly couple households. In addition, the health care policy for the elderly households of which member has a chronic disease is certainly necessary. Especially a health care plan for the elderly single households with lower income is in need. For the elderly couple households, the priority group of health care policy would be the high age group.

• 보건행정학회지
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• 제14권4호
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• pp.75-87
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• 2004

The purpose of this paper is to compare the amount of household health expenditures (HHE) and the proportion of health care expenditure to the household expenditure by ability to pay(ATP) levels. This study has focused on the influence of household ATP on HHE, estimating elasticity of health care expenditures for different ATP groups. For the empirical analysis, the Urban Households Survey Data of 2002 have been used. Our principal findings show that HHE are sensitive to changes in household ATP levels and that the group which is most responsive to changes in A TP level is the lower ATP group. These suggest that as households have less ATP, households with lower ATP reduce expenditures on health care in a proportional manner than those with higher ATP.

• 한국콘텐츠학회논문지
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• 제16권8호
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• pp.366-375
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• 2016

본 연구는 한국 의료보장제도에 있어서 의료비 부담과 민간의료보험 급여액의 소득계층별 불평등을 평가하고, 가구소득 불평등과의 관계를 확인하는데 목적이 있다. 이를 위해 2014년도 한국의료패널조사 자료를 활용하여, 의료비 부담에 따른 가구소득변화 지니계수를 산출하였다. 주요 분석결과를 살펴보면, 첫째, 우리나라 가구소득 불평등은 소득1분위 평균가구소득이 629만원인 반면, 10분위 소득은 1억 193만원으로 소득분위별 소득금액차이가 매우 컸고, 지니계수가 0.3756으로 불평등 정도가 컸다. 둘째, 가구소득분위별 건강보험과 의료급여 등 공적지원이 이루어지는 외래 입원진료 관련 의료비 부담 지니계수가 0.0761로 나타났으며, 공적제도의 지원이 없는 의료이용을 위한 교통비와 의료용품구입비 등을 모두 포함한 의료비 부담의 지니계수가 0.0878로 나타나서 의료비 부담의 불평등은 공적지원이 있는 부담과 공적지원이 없는 부담 모두 적었다. 가구소득차이와 관계없이 의료비를 부담하고 있는 것이다. 셋째, 가구소득 불평등과 의료비 부담의 관계를 확인하기 위하여 가구소득에서 의료비 부담을 제외하여 지니계수를 산출한 결과 기존 가구소득 지니계수보다 의료비 부담을 제외한 지니계수가 약간씩 증가하였다. 즉, 우리나라 가구의 의료비 부담은 소득계층별로 불평등하여서 가구소득의 불평등을 악화시키데 기여하고 있는 것이다. 이는 건강보험 의료급여와 같은 공적지원이 있는 의료비부담도 동일해서 공적제도가 가구소득 불평등을 약간 악화시켰다. 넷째, 민간의료보험 급여액 지니계수가 0.0927로 나타나서 민간보험 급여액의 불평등은 적었다. 아울러 가구소득과 민간보험급여를 합산하여 산정한 지니계수가 0.3756에서 0.3672로 감소하여서 민간의료보험을 통한 보험금 수입이 가구소득 불평등을 다소 약화시키는 것으로 나타났다.

• 보건행정학회지
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• 제20권3호
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• 보건행정학회지
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• 제18권4호
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• 보건행정학회지
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• 제14권2호
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

• 보건의료산업학회지
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• 제12권2호
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• pp.89-99
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• 2018

Objectives : To compare the degree of achievement of Universal Health Coverage (UHC) among 39 developing countries in Africa and to investigate the correlation between health care financing and the UHC index. Methods : For data, 14 UHC indexes were used in 2015 supplied by the World Health Organization (WHO). In addition, this study used a 10% of threshold point corresponding to the catastrophic health expenditures and a 25% of threshold points as a health care financing index. Results : It was found that there were significant difference among Least Low Developed Countries (LLDCs), Other Low Income Countries (Other LICs), Lower Middle Income Countiies (LMICs), Upper Middle Income Countires (UMICs) to compare the average value by nation on the UHC index. This study showed that the UHC index of LLDCs was lowest, but the average value was higher as it moved towards LMICs and UMICs. In addition, it was found that there was an average value difference among the groups like LLDCs, Other LICs, LMICs and UMICs. As a result of comparison, it was found that the spending of household health expenditure increased as LLDCs moved towards UMICs when the burden of household health expenditure was 25%. Conclusions : This study aimed to compare the UHC indexes of African nations and to investigate the correlation between the degree of spending of total expenditure on health and burden of household health expenditure and UHC, and its effect.

• 한국콘텐츠학회논문지
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• 제19권5호
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• pp.331-341
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• 2019

본 연구는 외환위기 이후 소득계층별 보건의료비 지출이 가구소득 불평등에 미치는 영향과 그 변화를 확인하기 위하여 1996년부터 2016년도 가계소득조사를 활용하여 지니계수를 시계열적으로 산출하였다. 도출된 결과와 함의는 다음과 같다. 첫째, 외환위기 이후 가구 총소득 불평등은 연도별로 다소 변화는 있지만 지속적으로 심화되어 왔다. 둘째, 소득계층별 보건의료비 지출은 고소득층이 더 많이 지출하는 다소 불평등한 수준을 지속적으로 유지하고 있다. 셋째, 가구소득 불평등에 대한 보건의료비 지출의 영향을 평가하기 위하여 보건의료비 지출을 제외한 가구소득에 대한 지니계수를 산출한 결과, 총소득 지니계수 보다 그 값이 커져서 가구의 보건의료비 지출로 인하여 소득불평등이 심화되는 것으로 나타났다. 보건의료비 지출로 인한 가구소득 불평등 심화현상은 외환위기 이후 지속적으로 증가하는 경향을 보였다. 국민의료비 부담을 감소시키기 위한 목적으로 건강보험보장성 강화 등 노력이 지속적으로 이루어지고 있지만 소득불평등 해소에는 기여하지 못하는 것이다. 향후 저소득층의 의료비 지출 감소를 위한 보다 저소득층을 위한 선택적인 의료비 지원제도의 마련이 필요할 것이다.

• 보건행정학회지
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• 제27권1호
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• pp.84-87
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• 2017

Catastrophic healthcare expenditure refers to out-of-pocket spending for healthcare exceeding a certain proportion of a household's income and can lead to subsequent impoverishment. The aim of this study was to investigate the proportion of South Korean households that experienced catastrophic healthcare expenditure between 2006 and 2015 using available data from the Korea Health Panel, National Survey of Tax and Benefit, and Household Income and Expenditure Survey. Frequencies and trend tests were conducted to analyze the proportion of households with catastrophic healthcare expenditure. Subgroup analysis was performed based on income level. The results of the Household Income and Expenditure Survey revealed that around 2.88% of households experienced catastrophic healthcare expenditure in 2015 and that this proportion was highest in the low income group. Results also showed a statistically significant increasing trend in the number of households with catastrophic healthcare expenditure (annual percentage change= 0.92%, p-value < 0.0001). Therefore, the findings infer a need to strengthen public health care financing and to particularly monitor catastrophic healthcare expenditure in the low income group.

• 응용통계연구
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• 제23권1호
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• pp.1-11
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• 2010

본 연구는 보건의료 가계소비지출 추계에 있어 가구원수별 가구 수 추계의 신뢰성과 효율성을 개선하기 위한 것이다. 이를 위해 다음과 같은 세 가지 연구결과를 제시하였다. 첫째, 기존 국민의료비 추계과정에서 이루어지고 있는 가구 원수별 가구 수의 추계는 우리나라 인구사회학적 변화추이를 충분히 고려하지 않았다. 그래서 그 결과의 신뢰성과 정책적 유용성 측면에서 심각한 문제가 발생하고 었다. 둘째, 이에 대한 실증적 근거로 기존 보건의료 가계소비지출 규모의 추계결과가 실제적인 규모에 비해 과소추계 되었음을 제시했다. 셋째, 보다 신뢰할 수 있고 효울적인 보건의료 가계소비지출 규모를 추계하기 위해서는 우리나라 인구사회학적 변화추이가 반영된 가구원수별 가구 수의 장래 추계결과를 활용해야 할 것이다. 그 대안으로 통계청에서 매 5 년 마다 주기적으로 조사하여 발표하고 있는 인구주택 총조사 가구 수 통계와 장래 추계가구 수의 증가율을 활용해야 함을 제시하고자 한다.