Out-of-Pocket Healthcare Spending by the Poor and Chronically Ill in the Republic of Korea

American Journal of Public Health, Vol. 97, No. 5, pp. 804-811, May 2007

8 Pages Posted: 1 May 2007

See all articles by Jennifer Prah Ruger

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine

Hakju Kim

Gyeongsang National University

Abstract

Objectives: We estimated out-of-pocket health care spending and out-of-pocket spending burden ratio employing household equivalent income in the Republic of Korea. We examined variations in out-of-pocket spending, estimated out-of-pocket spending burden ratio employing household equivalent income, and identified factors associated with out-of-pocket spending.

Methods: We used the 1998 Korean National Health and Nutrition Survey, a nationally representative survey of 39,060 individuals. Our analyses examined out-of-pocket spending, out-of-pocket spending burden ratio, and health care use by socioeconomic status, insurance type, health care facility type, and chronic condition after we controlled for sociodemographic variables.

Results: The lowest income quintile spent 12.5% of their total income out-of-pocket on medical expenditures, which was 6 times that of the highest income quintile (2%). Among those with 3 or more chronic conditions, low-income Koreans had the highest out-of-pocket spending burden ratio (20%), which was 5 times the spending burden among high-income Koreans (4%). In multivariate analyses, the number of chronic conditions, insurance type, health care use, and health care facility type were associated with out-of-pocket spending.

Conclusions: Out-of-pocket spending in Korea is regressive, because lower-income groups pay disproportionately more of their income compared with higher-income groups. Low-income individuals with multiple chronic conditions are particularly vulnerable.

Keywords: out-of-pocket spending, healthcare, Republic of Korea, equity, Hak-Ju Kim

JEL Classification: I11, I31

Suggested Citation

Prah Ruger, Jennifer and Kim, Hakju, Out-of-Pocket Healthcare Spending by the Poor and Chronically Ill in the Republic of Korea. American Journal of Public Health, Vol. 97, No. 5, pp. 804-811, May 2007, Available at SSRN: https://ssrn.com/abstract=983507

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

Hakju Kim

Gyeongsang National University ( email )

Chinju City, South Kyongsang
Korea, Republic of (South Korea)

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
256
Abstract Views
2,556
Rank
216,342
PlumX Metrics