Trends in out-of-pocket health care expenditures in Canada, by household income, 1997 to 2009.

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 highincome 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, 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. [ABSTRACT FROM AUTHOR]