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Age- and cause-specific contributions to the life expectancy gap between Medical Aid recipients and National Health Insurance beneficiaries in Korea, 2008–2017

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  • Jinwook Bahk
  • Hee-Yeon Kang
  • Young-Ho Khang

Abstract

Recipients of Medical Aid, a government-funded social assistance program for the poor, have a shorter life expectancy than National Health Insurance beneficiaries in Korea. This study aims to explore the contributions of age and major causes of death to the life expectancy difference between the two groups. We used the National Health Information Database provided by the National Health Insurance Service individually linked to mortality registration data of Statistics Korea between 2008 and 2017. Annual abridged life tables were constructed and Arriaga’s life expectancy decomposition method was employed to estimate age- and cause-specific contributions to the life expectancy gap between National Health Insurance beneficiaries and Medical Aid recipients. The life expectancy difference between National Health Insurance beneficiaries and Medical Aid recipients was 14.5 years during the period of 2008–2017. The age groups between 30 and 64 years accounted for 78.7% and 67.5% of the total life expectancy gap in men and women, respectively. Cancer was the leading cause of death contributing to excess mortality among Medical Aid recipients compared to National Health Insurance beneficiaries. More specifically, alcohol-attributable deaths (such as alcoholic liver disease, liver cancer, liver cirrhosis, and alcohol/substance abuse), suicide, and cardiometabolic risk factor–related deaths (such as cerebrovascular disease, ischemic heart disease, and diabetes) were the leading contributors to the life expectancy gap. To decrease excess deaths in Medical Aid recipients and reduce health inequalities, effective policies for tobacco and alcohol regulation, suicide prevention, and interventions to address cardiometabolic risk factors are needed.

Suggested Citation

  • Jinwook Bahk & Hee-Yeon Kang & Young-Ho Khang, 2020. "Age- and cause-specific contributions to the life expectancy gap between Medical Aid recipients and National Health Insurance beneficiaries in Korea, 2008–2017," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-11, November.
    • Handle: RePEc:plo:pone00:0241755
    DOI: 10.1371/journal.pone.0241755
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    References listed on IDEAS

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    1. Jang, Sung-In & Yi, Sang-Wook & Sull, Jae-Woong & Park, Eun-Cheol & Kim, Jae-Hyun & Ohrr, Heechoul, 2015. "Association between all-cause mortality and insurance status transition among the elderly population in a rural area in Korea: Kangwha Cohort Study," Health Policy, Elsevier, vol. 119(5), pages 680-687.
    2. Jae Kyung Suh & Jayoun Lee & Jeong-Hoon Lee & Sangjin Shin & Ha jin Tchoe & Jin-Won Kwon, 2018. "Risk factors for developing liver cancer in people with and without liver disease," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-13, October.
    3. Eduardo Arriaga, 1984. "Measuring and explaining the change in life expectancies," Demography, Springer;Population Association of America (PAA), vol. 21(1), pages 83-96, February.
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