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Disparities in Catastrophic Health Expenditure Between Urban and Rural Areas in South Korea

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In South Korea, the financial burden of healthcare expenses on households, particularly of those with deceased members, reveals significant urban-rural disparities. This study scrutinizes catastrophic health expenditure (CHE) by analyzing data over a decade, revealing that rural households face greater financial challenges. The research highlights the urgent need for policy intervention to address these imbalances and enhance health equity.

Examining the financial burden on households of deceased individuals in South Korea, this study underscores the pronounced disparities in healthcare costs between urban and rural regions. Utilizing ten years of data from the Korea Health Panel, the research investigates the prevalence of catastrophic health expenditure (CHE) and the ability of households to pay for healthcare.

Study Methods and Data Analysis

The study examined 869 deceased individuals and their households, adjusting annual household income and living costs based on equivalent household size. The difference between these values determined the household’s ability to pay. Out-of-pocket (OOP) expenses included copayments and uninsured healthcare costs for emergency room visits, inpatient care, outpatient treatments, and prescription medications. CHE was defined as OOP expenditure reaching or exceeding 40% of the household’s ability to pay. Confounding variables were controlled using ANCOVA, and χ2 analysis assessed CHE prevalence equity between urban and rural areas.

Key Findings

The study found rural households had fewer members, a higher rate of spousal presence, and a higher economic activity rate compared to urban households. Despite similar comorbidities and OOP expenditures, rural households had significantly lower annual incomes and abilities to pay. Consequently, CHE prevalence was notably higher in rural areas (77.6%) compared to urban areas (68.3%).

Implications for Policy and Practice

The findings highlight the necessity for targeted policy efforts to mitigate financial burdens on rural households. Enhancing social development and implementing comprehensive health policies are crucial to addressing these disparities and ensuring equitable healthcare access.

Concrete Takeaways

– Rural households face a higher prevalence of CHE due to lower income levels.
– Spousal presence and economic activity rates differ significantly between rural and urban households.
– Policy interventions must go beyond individual-level health access to address broader socio-economic factors.
– Equitable healthcare practices should be enforced to alleviate financial disparities between urban and rural regions.

In conclusion, the study emphasizes the critical need for broader social and policy measures to address the higher CHE risk in rural areas, driven by lower household income and payment capacity. These findings contribute to the growing evidence that income disparities significantly impact rural health outcomes, necessitating comprehensive strategies to ensure health equity across regions.

Original Article: Rural Remote Health. 2024 May;24(2):8566. doi: 10.22605/RRH8566. Epub 2024 May 21.

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