Characteristics and Health Care Spending of Persistently and Transiently High-cost Older Adults in Korea

Sungchul Park, Giryeon Bae

Research output: Contribution to journalArticlepeer-review


Objectives: This study examined differences in health care spending and characteristics among older adults in Korea by high-cost status (persistently, transiently, and never high-cost). Methods: We identified 1 364 119 older adults using data from the Korean National Insurance Claims Database for 2017-2019. Outcomes included average annual total health care spending and high-cost status for 2017-2019. Linear regression was used to estimate differences in the outcomes while adjusting for individual-level characteristics. Results: Persistently and transiently high-cost older adults had higher health care spending than never high-cost older adults, but the difference in health care spending was greater among persistently high-cost older adults than among transiently high-cost older adults (US$20 437 vs. 5486). Despite demographic and socioeconomic differences between transiently high-cost and never high-cost older adults, the presence of comorbid conditions remained the most significant factor. However, there were no or small differences in the prevalence of comorbid conditions between persistently high-cost and transiently high-cost older adults. Rather, notable differences were observed in socioeconomic status, including disability and receipt of Medical Aid. Conclusions: Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults in Korea.

Original languageEnglish
Pages (from-to)475-480
Number of pages6
JournalJournal of Preventive Medicine and Public Health
Issue number5
StatePublished - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023 The Korean Society for Preventive Medicine.


  • Comorbidity
  • Cost and cost analysis
  • Korea
  • Social determinants of health


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