|Financing resources and organization||Compulsory social health insurance based contribution (80%)|
|Population Coverage||About 97% of total population|
|Benefit coverage||Most curative services and drugs|
(e.g., As of 2009, direct OOPs accounted for about 35% of total treatment cost at the use of health care service which comprised 22% as the full payment for of non-covered service and 13% as copayments for covered service)
|Covered services: copayment rates and total cost
Some protection measures from high OOPs
|Health care provider payment mechanism||Fee for service payments (in principal)|
Prospective payments based on the Diagnostic Related Group (DRG) for several diseases, voluntary participation of hospitals
|Health care delivery systems||About 90% of health care services provided by private sector|
No gatekeeper system for the coordination among providers
Patients’ unconstrained freedom in choose providers & competitive settings
2.1. Data Source
2.2. Measurement & Statistics
2.2.1. Differences in Health Care Utilization among Income Groups
2.2.2. Differences in OOPs per Clinic Visit and per Inpatient Day among Income Groups
2.2.3. Catastrophic Health Care Expenditure and Impoverishment that Results from Paying for Health Care
3.1. Differences in Health Care Service Use among Income Groups
|Survey||Year||Sample Size||Response Rate (%)||Inclusion Criteria||Survey Content|
|Fourth National Health and Nutrition Examination Survey (KNHNES-IV)||2007||4594 (individual)||71.2||Individuals aged 20 and over except for dental clinic or hospital admission||Demographic characteristics|
Self-rated health status
|Frequency of visit to physician’s offices, clinics or outpatient clinics at hospitals in the previous two weeks (self-reported)|
|Frequency of admission to an acute hospital in the previous year (self-reported)|
|Direct out-of-pocket health care payments for the use of outpatient and inpatient services|
|Korean Household Income and Expenditure Survey (KHIES)||2007||8700 (households)||80||Households in urban areas and with family numbers of two or more||Household status with the number of family members, occupation and industry of the head of household and the spouse, the type of dwelling, etc.|
|Household income related items|
Household expenditure related items including food and medical service
|Average Frequency of Clinic Visits or Hospital Admissions)||0.549||0.113|
|Parameters||Estimates||95% CI||Estimates||95% CI|
|Cm (actual use)||−0.114||−0.134||−0.094||−0.073||−0.104||−0.042|
|Cn (need-expected use)||−0.106||−0.111||−0.102||−0.079||−0.083||−0.076|
|HIwv ( use after standardizing the differences in need and others *)||−0.006||−0.025||0.014||0.007||−0.024||0.037|
3.2. Differences in OOPs per Outpatient Visit and per Inpatient Day among Income Groups
|Income Group||No.||Mean||SD||Median||Ratio||95% CI|
|Income Group||No.||Mean||SD||Median||Ratio||95% CI|
3.3. Distribution of Households with Catastrophic Health Expenditure across Income Groups
4. Discussion and Conclusions
Conflicts of Interest
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