Changes in economic status of households associated with catastrophic health expenditures for cancer in South Korea.
BACKGROUND
Cancer imposes significant economic challenges for individuals, families, and society. Households of cancer patients often experience income loss due to change in job status and/or excessive medical expenses. Thus, we examined whether changes in economic status for such households is affected by catastrophic health expenditures.


METHODS
We used the Korea Health Panel Survey (KHPS) Panel 1st-4th (2008- 2011 subjects) data and extracted records from 211 out of 5,332 households in the database for this study. To identify factors associated with catastrophic health expenditures and, in particular, to examine the relationship between change in economic status and catastrophic health expenditures, we conducted a generalized linear model analysis.


RESULTS
Among 211 households with cancer patients, 84 (39.8%) experienced catastrophic health expenditures, while 127 (40.2%) did not show evidence of catastrophic medical costs. If a change in economic status results from a change in job status for head of household (job loss), these households are more likely to incur catastrophic health expenditure than households who have not experienced a change in job status (odds ratios (ORs)=2.17, 2.63, respectively). A comparison between households with a newly-diagnosed patient versus households with patients having lived with cancer for one or two years, showed the longer patients had cancer, the more likely their households incurred catastrophic medical costs (OR=1.78, 1.36, respectively).


CONCLUSIONS
Change in economic status of households in which the cancer patient was the head of household was associated with a greater likelihood that the household would incur catastrophic health costs. It is imperative that the Korean government connect health and labor policies in order to develop economic programs to assist households with cancer patients.
Department of Public Health, Graduate School, Yonsei University, Seoul, Korea E-mail : ecpark@yuhs.ac.
Jae-Woo
JW
Choi
Kyoung-Hee
KH
Cho
Young
Y
Choi
Kyu-Tae
KT
Han
Jeoung-A
JA
Kwon
Eun-Cheol
EC
Park
D000368:Aged; D002388:Catastrophic Illness / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005382:Financing, Personal / Q000191:economics*; D005500:Follow-Up Studies; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics*; D012959:Socioeconomic Factors