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Original Article
Relationship Between Catastrophic Health Expenditures and Income Quintile Decline
Jeong-Hee Kang, Chul-Woung Kim
Osong Public Health Res Perspect. 2018;9(2):73-80.   Published online April 30, 2018
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  • 7 Citations
AbstractAbstract PDF

The aims of this study were to investigate the proportion of households facing catastrophic health expenditures based on household income quintiles, and to analyze the relationship between expenditures and household income quintile decline.


Study data were obtained from an annually conducted survey of the 2012–2013 Korean health panel. There were 12,909 subjects aged 20–64 years from economically active households, whose income quintile remained unchanged or declined by more than one quintile from 2012 to 2013. Logistic regression analysis was performed to determine whether catastrophic health expenditures in 2012 were related to more than one quintile income decline in 2013.


Households facing catastrophic health expenditures of ≥ 40%, ≥ 30%, and ≥ 10% of a household’s capacity to pay, were 1.58 times (p < 0.003), 1.75 times (p < 0.000), and 1.23 times (p < 0.001) more likely to face a decline in income quintile, respectively.


Over a 1 year period, the proportion of households facing more than one quintile income decline was 16.4%, while 2.1% to 2.5% of households in Korea faced catastrophic health expenditures. Catastrophic health expenditure experienced in 2012 was significantly associated with income quintile decline 1 year later. Therefore, lowering the proportion of households with catastrophic health expenditure may reduce the proportion of households with income quintiles decline.


Citations to this article as recorded by  
  • Association of Depressive Symptoms With Health Service Use and Catastrophic Health Expenditure Among Middle-Aged and Older Chinese Adults: Analysis of Population-Based Panel Data
    Rui Yan, Lifeng Li, Xiaoran Duan, Jie Zhao
    Journal of the American Medical Directors Associat.2023; 24(5): 664.     CrossRef
  • Gastos catastróficos em saúde: análise da associação com condições socioeconômicas em Minas Gerais, Brasil
    Jéssica de Brito Macedo, Alexandra Crispim Boing, Juliana Mara Andrade, Helton Saulo, Rodrigo Nobre Fernandez, Fabíola Bof de Andrade
    Ciência & Saúde Coletiva.2022; 27(1): 325.     CrossRef
  • What Policy Approaches Were Effective in Reducing Catastrophic Health Expenditure? A Systematic Review of Studies from Multiple Countries
    HyunWoo Jung, Kwang-Soo Lee
    Applied Health Economics and Health Policy.2022; 20(4): 525.     CrossRef
  • Elderly chronic diseases and catastrophic health expenditure: an important cause of Borderline Poor Families’ return to poverty in rural China
    Xiaocang Xu, Haoran Yang
    Humanities and Social Sciences Communications.2022;[Epub]     CrossRef
  • Does Elderly Chronic Disease Hinder the Sustainability of Borderline Poor Families’ Wellbeing: An Investigation From Catastrophic Health Expenditure in China
    Xiaocang Xu, Haoran Yang
    International Journal of Public Health.2022;[Epub]     CrossRef
  • The Relationship between Unmet Healthcare Needs Due to Financial Reasons and the Experience of Catastrophic Health Expenditures
    Jeong-Hee Kang, Chul-Woung Kim
    Journal of Korean Academy of Community Health Nurs.2021; 32(1): 95.     CrossRef
  • Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries: a cross sectional analysis of WHO-SAGE survey
    Rui Huang, Bishwajit Ghose, Shangfeng Tang
    BMC Geriatrics.2020;[Epub]     CrossRef

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