Health Policy Manag.  2024 Sep;34(3):319-333. 10.4332/KJHPA.2024.34.3.319.

A Study on the Factors Influencing Catastrophic Health Expenditure of the Elderly Living Alone

• Kim JH
• Kim H
• Moon S
• Park JH
• Jeong HS

• KMID: 2562588
• DOI: http://doi.org/10.4332/KJHPA.2024.34.3.319

Abstract

Background
This study aims to identify the factors that influence the incidence of catastrophic health expenditure (CHE) for the elderly living alone and to discuss how to manage CHE for the elderly living alone.
Methods
This study utilizes 6th (2016), 7th (2018), and 8th (2020) data from the Korean Longitudinal Study of Aging to identify the incidence rate of CHE among the elderly living alone and conducts a panel logit analysis. The dependent variable is the incidence of CHE (thresholds: 10%, 20%, 30%), and the independent variables include demographic factors (gender, age group, region), socioeconomic factors (education level, economic activity status, income quintile, financial support rate from children), health-related factors (subjective health status, regular exercise, smoking, drinking, number of chronic diseases), and healthcare coverage factors (type of health insurance, private health insurance).
Results
Descriptive statistics classified by gender show that female elderly living alone are more vulnerable than male elderly living alone in terms of disease prevalence and socioeconomic status. In addition, the incidence of CHE is higher for elderly women living alone than for elderly men living alone across all thresholds. The main results of the panel logit analysis show that higher education, income quintile, and financial support rate from children are associated with lower odds of CHE, while poorer subjective health and a higher number of chronic diseases are associated with higher odds of CHE. Medical aid recipients are less likely to incur CHE than those covered by national health insurance.
Conclusion
The implications of this study are as follows. First, vulnerable elderly living alone with multiple chronic diseases and low income and education levels are more likely to incur CHE. Second, it is necessary to review policies such as a CHE support program and chronic disease management programs focused on vulnerable elderly individuals living alone. Third, the CHE support program should be operated in a patientcentered manner, with consideration given to a customized system for selecting and supporting elderly individuals living alone who are in need.

Keyword

Elderly living alone; Catastrophic health expenditure; Incidence; Catastrophic health expenditure support program