Health Policy Manag.  2018 Dec;28(4):369-377. 10.4332/KJHPA.2018.28.4.369.

The Effect of Gender on Catastrophic Health Expenditure in South Korea: Gender-Based Approach by Subgroup Analysis

  • 1Department of Public Administration, Ewha Womans University, Seoul, Korea.
  • 2Department of Chronic Disease Control Research, Korea Centers for Disease Control and Prevention, Cheongju, Korea.


Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data.
This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model.
Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases.
Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.


Catastrophic health expenditure; Sex analysis; Gender analysis
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