Abstract

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Background
Keywords
Findings
Author
What is already known on this subject?
What does this study add?

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Background

Canadian households are spending an increasing share of their household income on health care not covered by public plans. This study investigates trends in out-of-pocket expenditures for health care services and products by household income quintile from 1997 to 2009.

Data and methods

Biennial estimates from the Survey of Household Spending between 1997 and 2009 were used to examine changes in out-of-pocket health care expenditures, by household income quintile. The statistical significance of these changes was assessed using linear and logistic regression.

Results

In 2009, the percentage of after-tax household income spent on health care among low-income households (5.7%) was nearly twice that of high-income households (2.6%). Approximately 40% of households in the two lowest income quintiles spent more than 5% of their total after-tax income on health care services and products, compared with 14% of households in the highest income quintile. The increase in spending between 1997 and 2009 was greatest for households in the lowest income quintile (63%).

Interpretation

Out-of-pocket health care expenditures have increased for households in all income quintiles, but the relative increase was greatest among households in lower income quintiles.

Keywords

Cost of illness, dental care, health expenditures, health insurance, prescription drugs

Findings

The private sector plays an active role in financing health care services and products in Canada, most notably in the areas of prescription medication, dental care and private insurance. Private sector expenditures are derived primarily from private insurance and out-of-pocket expenditures (excluding insurance premiums) and totaled $56.9 billion in 2010, which represented about 30% of total health care spending. This percentage has remained relatively unchanged for several decades. Since the late 1980s, however, as a share of private expenditures on health care, out-ofpocket spending dropped from 58% to 49%. [Full Text]

Author

Claudia Sanmartin (1-613-951-6059; claudia.sanmartin@statcan.gc.ca) and Deirdre Hennessy are with the Health Analysis Division, and Yuqian Lu is with the Social Analysis Division at Statistics Canada, Ottawa, Ontario, K1A 0T6. Michael Robert Law is with the University of British Columbia, Vancouver, British Columbia.

What is already known on this subject?

  • Out-of-pocket expenditures for health care services have been shown to represent a cost burden for some Canadians, which can lead to reduced use of services.
  • Out-of-pocket health care spending rose in the last decade, but it is not known if the pace of increase differed by household income.

What does this study add?

  • Since 1997, out-of-pocket health care spending rose for households in all income quintiles, but increases were greater for lower-income households.
  • In 2009, out-of-pocket health care spending by households in the lowest income quintile averaged  5.7% of their after-tax income, double the percentage (2.6%) for households in the highest quintile.
  • In 2009, almost 40% of households in the two lowest income quintiles spent at least 5% of their total after-tax income on health care; this was the case for 14% of households in the highest income quintile.
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