title: Medical security and catastrophic health expenditures among households containing persons with disabilities in Korea: a longitudinal population-based study.
abstract: Although persons with disabilities need access to comprehensive and consistent healthcare services, a significant number of the poor with disabilities do not receive Medical-Aid due to the conditions of eligibility. We aimed to compare the financial burden of healthcare services between two groups of poor persons with disabilities: those not enrolled in Medical-Aid and Medical-Aid enrollees.
  
  
  
  This study used the 1st-8th data (2008-2014 year) of Panel Survey of Employment for the Disabled (PSED) conducted by the Korea Employment Agency for the Disabled. We classified adults who did not exceed 100 % of the poverty level into two groups (N = 3,010). The first group consisted of enrollees in Medical-Aid (n = 1,259) and the second group comprised those not enrolled in Medical-Aid (n = 1,325). We applied generalized estimating equations (GEEs) to assess the independent effect of enrollment in Medical-Aid on catastrophic health expenditures (CHE).
  
  
  
  We found that about 4.2 % of the poor not enrolled in the Medical-Aid experienced CHE and the poor not enrolled in Medical-Aid were 2.1 times more likely to experience CHE than Medical-Aid enrollees after applying multivariate models adjusted for several covariates.
  
  
  
  Given the additional expenses for treatment and rehabilitation caused by disability-related health problems, persons with disabilities are more likely to face barriers to needed medical services. Thus, policy makers need to expand the number of people receiving Medical-Aid by loosening the strict criteria for those with disabilities.
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.|Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Nam
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.|Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea. LEEVAN@yuhs.ac.|Department of Hospital Management, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. LEEVAN@yuhs.ac.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D054625:Healthcare Disparities / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056910:Republic of Korea; D011795:Surveys and Questionnaires
keywords: Blind spot; Catastrophic health expenditure; Medical-Aid; Persons with disability