Economic Burden of Hwabyeong in South Korea: An Analysis of Direct, Non-Medical, and Indirect Costs
Author(s)
CHING WEN HUANG, PhD1, Bo-Hyoung Jang, MPH, PhD, MD2;
1Kyunghee University, Research Professor, Seoul, Korea, Republic of, 2Kyung Hee University, Seoul, Korea, Republic of
1Kyunghee University, Research Professor, Seoul, Korea, Republic of, 2Kyung Hee University, Seoul, Korea, Republic of
OBJECTIVES: Hwa-byung, a psychosomatic disorder deeply rooted in Korean culture and often triggered by unresolved anger from significant stress events, is prevalent in South Korea and imposes significant socioeconomic costs. This study aims to estimate the total economic burden of Hwa-byung by analyzing its direct medical costs, non-medical expenses, and productivity losses using publicly available data.
METHODS: Direct medical costs were calculated based on total medical expenses and out-of-pocket costs derived from HIRA (Health Insurance Review & Assessment Service) open data. Non-medical expenses, including transportation costs and time costs, were estimated using the Korean Medical Panel. Time costs were calculated based on round-trip travel and treatment waiting times, with age-specific hourly wages and employment rates obtained from the Employment Structure and Working Conditions Survey conducted by Statistics Korea. Productivity losses were assessed using Productivity Adjusted Life Years (PALYs), with estimates informed by prior depression research.
RESULTS: Hwa-byung’s economic burden in South Korea for 2017 was estimated as follows:
CONCLUSIONS: Hwa-byung, often associated with depression and other mental health disorders, represents a significant economic burden in South Korea. This study estimates its disease burden to be far greater than other major diseases in the country, including diabetes, cancer, liver disease, and cardiovascular conditions. The findings emphasize the need for targeted mental health interventions and greater recognition of culturally specific psychosomatic disorders in health policy and resource allocation.<!-- notionvc: d081d000-935b-44bd-be15-23d475d88739 -->
METHODS: Direct medical costs were calculated based on total medical expenses and out-of-pocket costs derived from HIRA (Health Insurance Review & Assessment Service) open data. Non-medical expenses, including transportation costs and time costs, were estimated using the Korean Medical Panel. Time costs were calculated based on round-trip travel and treatment waiting times, with age-specific hourly wages and employment rates obtained from the Employment Structure and Working Conditions Survey conducted by Statistics Korea. Productivity losses were assessed using Productivity Adjusted Life Years (PALYs), with estimates informed by prior depression research.
RESULTS: Hwa-byung’s economic burden in South Korea for 2017 was estimated as follows:
- Direct medical costs: 205.74 billion KRW, including 149.30 billion KRW covered by national insurance and 56.44 billion KRW (27.43%) borne by patients as out-of-pocket expenses.
- Non-medical expenses: 968.8 million KRW for transportation costs and 13.95 billion KRW for time costs.
- Indirect costs: Informal medical expenses were estimated at 2.37 billion KRW.
- Productivity losses: Totaled 835.74 billion KRW annually for 13,757 patients.
CONCLUSIONS: Hwa-byung, often associated with depression and other mental health disorders, represents a significant economic burden in South Korea. This study estimates its disease burden to be far greater than other major diseases in the country, including diabetes, cancer, liver disease, and cardiovascular conditions. The findings emphasize the need for targeted mental health interventions and greater recognition of culturally specific psychosomatic disorders in health policy and resource allocation.<!-- notionvc: d081d000-935b-44bd-be15-23d475d88739 -->
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE335
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Mental Health (including addition), STA: Alternative Medicine