OBJECTIVES: The purpose of this study is to explain the factors influencing the occurrence of Catastrophic Health Expenditure(CHE) of households with elderly. According to the WHO, catastrophic health expenditure occurs when direct health care spending exceeds 40% of a household’s capacity to pay, Since the elderly gradually loses opportunities for economic activities, the fixed costs of medical expenses increase and they are more likely to be exposed to CHE. This study focused on the incidences of CHE in South Korea, and examined the factors influencing the incurrence of CHE depending on whether the elderly in households or not.

METHODS: 2020 Korea Health Panel(KHP) was used for conducting analysis. We defined CHE as household’s health expenditure exceeding 20%~40% thresholds level of the household’s capacity-to-pay. And Logistic regression was applied to identify factors affecting the occurrence of CHE at threshold levels.

RESULTS: This study was carried out utilizing data collected via surveys of 5,740 households of which 2,877 elderly households. At the 40% threshold, the percent of Catastrophic Health Expenditure occurence was 23.6% in elderly-householder group, but it was only 4.12 % in non-elderly householder group. We found that the household income, the ratio of disabled members affected the occurrence of CHE in elderly householder group, but it had no effect on household without elderly. In elderly householder group, the odds of experiencing catastrophic health expenditure were 5.4(95% C.I:3.16-9.71) times higher for highest income household and 1.95(95% C.I:1.38-2.75) times higher for higher chronic disease rate(%).

CONCLUSIONS: The results of the study showed that CHE are not only affected by out of pocket money, but also by the presence or absence of the elderly in the household. It is considered that the factors having effect on the CHE in elderly household must be taken into regard on establishing the measures for preventing the occurrence of CHE.