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Comparative Study
. 2017 Aug;13(1):43-58.
doi: 10.12927/hcpol.2017.25192.

Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014

Lesley J J Soril  1 , Ted Adams  2 , Madeleine Phipps-Taylor  3 , Ulrika Winblad  4 , Fiona Clement  5
Affiliations
Comparative Study

Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014

Lesley J J Soril et al. Healthc Policy. 2017 Aug.

Abstract
in English, French

Objective: To compare cost-related non-adherence (CRNA), serious problems paying medical bills and average annual out-of-pocket cost over time in five countries.

Methods: Repeated cross-sectional analysis of the Commonwealth Fund International Health Policy survey from 2004 to 2014. Responses were compared between Canada, the UK, Australia, New Zealand and the US.

Results: Compared to the UK, respondents in Canada, Australia and New Zealand were two to three times and respondents in the US were eight times more likely to experience CRNA; these odds remained stable over time. From 2004 to 2014, Canadian respondents paid US $852-1,767 out-of-pocket for care. The US reported the largest risks of serious problems paying for care (13-18.5%), highest out-of-pocket costs (US $2,060-3,319) and greatest rise in expenditures.

Interpretation: Over the 10-year period, financial barriers to care were identified in Canada and internationally. Such persistent challenges are of great concern to countries striving for equitable access to healthcare.

Objectif:: Comparer, dans cinq pays et au cours du temps, le non-respect lié aux coûts (NRLC), les problèmes graves concernant le paiement des factures pour services médicaux et la moyenne annuelle des dépenses non remboursées.

Méthodes:: Analyse transversale répétée des enquêtes internationales du Fonds du Commonwealth sur les politiques de santé, de 2004 à 2014. Nous avons comparé les réponses du Canada, du Royaume-Uni (R.-U.), de l'Australie, de la Nouvelle-Zélande et des États-Unis (É.-U.).

Résultats:: Comparativement au R.-U., les répondants du Canada, de l'Australie et de la Nouvelle-Zélande sont 2 à 3 fois plus enclins, et ceux des É.-U. 8 fois plus enclins, à vivre une expérience de NRLC; ces probabilités demeurent stables en fonction du temps. De 2004 à 2014, les répondants canadiens ont indiqué des dépenses non remboursées de 852 à 1 767 $US. Ceux des É.-U. ont indiqué les plus grands risques de problèmes graves concernant le paiement pour les soins (de 13 à 18,5 %), les dépenses non remboursées les plus élevées (entre 2 060 et 3 319 $US) et la plus grande croissance des dépenses.

Interprétation:: Pour la période de dix ans, nous avons repéré les obstacles financiers pour les soins au Canada et à l'international. De tels défis constants constituent une préoccupation pour les pays qui s'efforcent d'assurer un accès équitable aux services de santé.

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Figures

Figure 1.
Figure 1.
Average annual out-of-pocket payments for medical treatments and services reported among the (a) general population and (b) older and/or sicker adults in Canada, Australia, New Zealand, the UK and the US
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