도시가계의 소득계층별 과부담의료비 실태

초록

This study defined `Catastrophic Health Expenditure (CHE)` as spending more than some pre-specified percent (10?30%) of an urbanite`s household income on health care. Their total expenditure and the monthly mean expenditure outlay per household among income groups were analyzed together with their incidence during the period between 1998 and 2002. Additionally, we have identified influencing factors on their frequency of healthcare requirements by using the generalized estimating equations (GEEs) to account for the correlation between observations in generalized linear models. The data that we are using were taken from the 1998 -- 2002 Urban Household Expenditure Surveys. The results of this study show that the ratio (10.9?39.2%) of health care costs of the households with catastrophic health care expenditures to the total households` healthcare expenditures were higher than the proportions (2.0--11.8%) of total households They were the same cases, however the monthly mean health expenditure per household was significantly less in the poor(p<0.05). The incidence rates in the lowest income group were increased 1.5?1.9 times between 1998 and 2002. But, on the other hand, the other groups did not increase to that extent. Odds ratios of its incidence rate were significantly higher in only the lowest income group compared to the highest income group in both before (1.39?2.02, p<0.05 ) and just after that (1.13?1.84, p<0.05). The less family members there were with more of them being elderly, the higher the odds ratios of their incidence rates. Incidences of catastrophic health care expenditure may be potential things that contribute to the deficit of the national budget for health security. Additionally it is a financial burden that causes the poor to live in impoverishment. Consequently incidences of catastrophic health care expenditures need to be thoroughly investigated and more closely managed. As a priority, health security policies need to be developed that guarantee health coverage for the lowest income groups that have more elderly family members.

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