title: Growth in private payments for health care by Canadian households.
abstract: BACKGROUND
  Despite first-dollar public coverage for hospital and physician services, Canadians spend more privately on health care than citizens of most other developed countries. We quantified recent growth in private payments by Canadian households for health care.
  
  
  METHODS
  Using data from 163,081 respondents to Statistics Canada's annual Survey of Household Spending from 1998 to 2009, we calculated inflation-adjusted per-household spending on private health insurance premiums and out-of-pocket payments on six types of health care services. Further, we estimated the prevalence and some socio-economic determinants of households spending over 10% of after-tax income on health care using logistic regression.
  
  
  RESULTS
  We found that Canadian households spent $19.8 billion on private payments for health care in 2009. This represents an average of $1523 per household-a 37% increase over 1998. The top three spending categories in 2009 were private health insurance premiums ($5.9 billion), dental ($4.9 billion) and prescription drugs ($4.2 billion). Even after adjusting for inflation, expenditure on every category of health care spending increased between 1998 and 2009. The proportion of households spending more than 10% of after-tax income on health care increased by 56% (from 3.3% to 5.2%). Households including a senior, with a low income, and in British Columbia or the Atlantic Provinces were significantly more likely to reach this threshold.
  
  
  CONCLUSIONS
  Over the period studied, the burden of private health care expenditures increased substantially for Canadian households. As direct charges reduce the use of necessary health care services, investigation into the health consequences of these increases is warranted.
authors: The Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 201-2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada. mlaw@chspr.ubc.ca
authors: Michael R
authors: MR
authors: Law
authors: Jamie R
authors: JR
authors: Daw
authors: Lucy
authors: L
authors: Cheng
authors: Steven G
authors: SG
authors: Morgan
mesh_terms: D002170:Canada / Q000453:epidemiology; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D005191:Family Characteristics; D005382:Financing, Personal / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000191:economics; D012959:Socioeconomic Factors
chemical_list: D055553:Prescription Drugs