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Assessing progressivity and catastrophic effect of out-of-pocket payments for healthcare in Canada: 2010-2015

TitleAssessing progressivity and catastrophic effect of out-of-pocket payments for healthcare in Canada: 2010-2015
Year of Publication2018
AuthorsEdmonds, S.
UniversityDalhousie University
CityHalifax, NS
Keywordscanada, equity, health, healthcare economics, healthcare financing, out-of-pocket payments
Abstract

Equity in healthcare is an important policy objective of the Canadian healthcare system. Out-of-pocket (OOP) expenses by Canadian households account for a substantial share of total healthcare expenditures (15%). Using data from Statistics Canada's Survey of Household Spending (SHS), this study examines the progressivity and catastrophic effect of OOP expenditures for healthcare services in Canada over the period 2010 to 2015 inclusive. The Kakwani Progressivity Index (KPI) was used to measure the progressivity of OOP payments for healthcare for each year of the study period. The catastrophic effect of OOP payments was calculated using a threshold 10% of total household consumption. The computed KPI indicated that OOP payments are a regressive source of healthcare funding in Canada and the regressivity of OOP payments has increased over the study period. This indicates that the distribution of OOP expenses in Canada is not equitable and the contribution of households from their total consumption to healthcare as OOP payments decreases as their consumption increase. Furthermore, the results suggested that 5-7% of Canadian households face catastrophic OOP healthcare payments. Proportion of households with catastrophic OOP healthcare payments was higher in rural areas compared with urban areas over the study period. Policies to enhance financial risk protection among low-income and rural households are required to improve equity in healthcare financing in Canada.

URLhttps://dalspace.library.dal.ca/handle/10222/74181
Document URLhttps://dalspace.library.dal.ca/xmlui/bitstream/handle/10222/74181/Edmonds-Sterling-MHA-HESA-August-2018.pdf