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NATIONAL HEALTH
EXPENDITURE TRENDS
1975 –2002
ANALYTICAL FOCUS:
Hospital Expenditure
Trends by Function
and Type
National Health Expenditure Trends
1975–2002
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ISBN 1-55392-120-8 (PDF)
 2002 Canadian Institute for Health Information
Cette publication est disponible en français sous le titre :
« Tendances des dépenses nationales de santé, 1975 à 2002 »
ISBN 1-55392-121-6 (PDF)
National Health Expenditure Trends 1975–2002
Table of Contents
Acknowledgments .................................................................................................... i
Highlights ............................................................................................................... iii
Introduction ............................................................................................................ 1
Overview................................................................................................................ 3
Total Health Expenditure........................................................................................ 3
Total Health Expenditure Per Capita......................................................................... 4
Total Health Expenditure and Economic Growth ........................................................ 5
Total Health Expenditure by Source of Finance ......................................................... 7
Total Health Expenditure by Use of Funds .............................................................. 15
Provincial and Territorial Government Health Expenditure by Age and Sex .................. 24
Provincial and Territorial Government Health Expenditure Standardized
for Age and Sex ................................................................................................. 30
Health Expenditures in the Provinces and Territories ................................................ 32
International Comparisons .................................................................................... 40
Analytical Focus—Hospital Expenditure by Functional Centre and by
Type of Expense—1976 to 1999............................................................................. 57
Introduction ....................................................................................................... 57
Section 1: Hospital Expenditure Trends.................................................................. 58
Section 2: Hospital Expenditure by Functional Centre .............................................. 61
Section 3: Hospital Expenditure by Type of Expense................................................ 69
Section 4: Hospital Expenditure by Functional Centre and Type of Expense ................ 73
Section 5: Hospital Expenditure by Hospital Size ..................................................... 76
Conclusions ....................................................................................................... 81
National Health Expenditure Database—Roadmap Feasibility Studies ............................ 85
Project Goal and Scope........................................................................................ 85
Provincial and Territorial Government Expenditure by Age and Sex (2000) ................. 85
The Impact of Regionalization on National Health Expenditures (June 2000) ............... 86
Home Care Estimates in National Health Expenditures (July 2001) ............................ 87
Long Term Residential Care (June 2002)................................................................ 88
Public Health and Administrative Costs (June 2002)................................................ 89
Price Indexes Used in National Health Expenditures (August 2001)............................ 90
Reconciliation of NHEX with Financial Management Statistics (Statistics Canada) ....... 91
National Health Expenditure Trends 1975–2002
Table of Contents (cont'd)
Methodological Notes............................................................................................. 93
Concepts and Definitions ..................................................................................... 93
Major Data Limitations......................................................................................... 99
Collection and Non-Response ............................................................................. 100
Major Changes from Previous Years .................................................................... 114
Revision History................................................................................................ 114
Source of Data ................................................................................................. 119
Data Tables ........................................................................................................ 123
Series A—Summary Data, Canada ...................................................................... 125
Series B—Total Health Expenditure by Source of Finance,
by Province/Territory and Canada (Selected Tables)............................................... 153
Series E—Provincial/Territorial Government Health Expenditure, by Age and Sex,
by Province/Territory and Canada (Selected Tables)............................................... 171
Comprehensive versions of Series A to G data tables and the Appendices Microsoft® Excel©
format are available for download with the electronic version of this report. All references to
the CD-ROM throughout this report refer to these data tables.
National Health Expenditure Trends 1975–2002
List of Figures
Figure 1
Total Health Expenditure, Canada, 1975 to 2002..................................... 3
Figure 2
Total Health Expenditure, Annual Growth Rates in Constant 1997 Dollars,
Canada, 1976 to 2002 ......................................................................... 4
Figure 3
Total Health Expenditure Per Capita, Canada, 1975 to 2002 ..................... 4
Figure 4
Total Health Expenditure Per Capita, Annual Growth Rates in Constant
1997 Dollars, Canada, 1976 to 2002 ..................................................... 5
Figure 5
Total Health Expenditure as a Percentage of Gross Domestic Product,
Current Dollars, Canada, 1975 to 2002 .................................................. 6
Figure 6
Health Expenditure and GDP Trends, Constant Dollar Indices
(1975 = 100), Canada, 1975 to 2002................................................... 6
Figure 7
Health Expenditure by Source of Finance, Canada, 1975 to 2002 .............. 8
Figure 8
Health Expenditure by Source of Finance, Constant Dollar Indices
(1975 = 100), Canada, 1975 to 2002................................................... 9
Figure 9
Growth in Real Per Capita Public and Private Health Expenditure and
the Private Share, Canada, 1976 to 2002 ............................................. 10
Figure 10
Private Sector Health Expenditure, Annual Growth of Selected Sources
of Finance, Canada, 1989 to 2000 ...................................................... 14
Figure 11
Total Health Expenditure by Use of Funds, Canada, 2000 ....................... 15
Figure 12
Total Health Expenditure, Selected Uses of Funds, Canada,
1975 to 2002—Current Dollars ........................................................... 16
Figure 13
Public and Private Shares of Total Health Expenditure, by Use of Funds,
Canada, 2000 ................................................................................... 16
Figure 14
Hospitals' Share of Total Provincial Government Health Expenditure
and Total Health Expenditure, Canada, 1975 to 2002............................. 17
Figure 15
Private Sector Hospital Expenditure, Canada, 1975 to 2000.................... 18
Figure 16
Drugs by Source of Finance and Type, Canada, 2000............................. 20
Figure 17
Prescribed Drug Expenditure, Public Sector vs. Private Sector,
Canada, 1975 to 2002 ....................................................................... 20
National Health Expenditure Trends 1975–2002
List of Figures (cont’d)
Figure 18
Other Professionals Expenditure by Source of Finance and Type,
Canada, 2000 ................................................................................... 22
Figure 19
Provincial/Territorial Government Hospital Expenditure, by Age and Sex,
Canada, 2000 ................................................................................... 26
Figure 20
Provincial/Territorial Government Hospital Expenditure Per Capita, by
Age and Sex, Canada, 2000 ............................................................... 26
Figure 21
Provincial/Territorial Government Physician Expenditure, by Age and
Sex, Canada, 2000 ............................................................................ 27
Figure 22
Provincial/Territorial Government Physician Expenditure Per Capita, by
Age and Sex, Canada, 2000 ............................................................... 28
Figure 23
Total Provincial/Territorial Government Health Expenditure, by Age and
Sex, Canada, 2000 ............................................................................ 29
Figure 24
Total Provincial/Territorial Government Health Expenditure Per Capita,
by Age and Sex, Canada, 2000 ........................................................... 29
Figure 25
Total Provincial/Territorial Government Health Expenditure Per Capita,
Age-Sex Standardized versus Actual, by Province/Territory
and Canada, 2000 ............................................................................. 31
Figure 26
Public and Private Sector Health Expenditure Per Capita, 1988 to 2002,
by Province and Territory—Current Dollars ............................................ 34
Figure 27
Real Average Annual Rates of Growth of Public and Private Expenditure
Per Capita, by Province/Territory and Canada, 1975 to 1990................... 37
Figure 28
Real Average Annual Rates of Growth of Public and Private Expenditure
Per Capita, by Province/Territory and Canada, 1990 to 1996................... 38
Figure 29
Real Average Annual Rates of Growth of Public and Private Expenditure
Per Capita, by Province/Territory and Canada, 1996 to 2000................... 39
Figure 30
Total Health Expenditure as a Percent of GDP, Twelve Selected
Countries, 2000 ................................................................................ 42
Figure 31
Public Sector Health Expenditure as a Percent of GDP, Twelve
Selected Countries, 2000 ................................................................... 44
National Health Expenditure Trends 1975–2002
List of Figures (cont’d)
Figure 32
Private Sector Health Expenditure as a Percent of GDP, Twelve Selected
Countries, 2000............................................................................. 44
Figure 33
Total Health Expenditure Per Capita in US Dollars, Twelve Selected
Countries, 2000............................................................................. 45
Figure 34
Public Sector Health Expenditure Per Capita in US Dollars, Twelve
Selected Countries, 2000................................................................ 46
Figure 35
Private Sector Health Expenditure Per Capita in US Dollars, Twelve
Selected Countries, 2000................................................................ 47
Figure 36
Expenditure on Personal Health Care as a Percent of Total Health
Expenditure, Eleven Selected Countries, 2000 ................................... 48
Figure 37
Public Share of Total Health Expenditure, Twelve Selected
Countries, 2000............................................................................. 49
Figure 38
Public Share of Expenditure on Medical Services, Eleven Selected
Countries, 2000............................................................................. 49
Figure 39
Public Share of Expenditure on Medical Goods, Eleven Selected
Countries, 2000............................................................................. 50
Figure 40
Percent of Total Health Expenditure Financed by the Public Sector,
by Source of Finance, Twelve Selected Countries, 2000 ..................... 51
Figure 41
Percent of Total Health Expenditure Financed by the Private Sector,
by Source of Finance, Twelve Selected Countries, 2000 ..................... 52
Figure 42
Hospital Expenditure Trends, Canada, 1976 to 1999 .......................... 58
Figure 43
Approved Beds in Hospitals Per Thousand Population, Canada, 1980/1981
to 2000/2001................................................................................ 60
Figure 44
Distribution of Hospital Expenditure by Functional Centre, Canada ........ 64
Figures 45–49 Share of Hospital Expenditure by Selected Functional Centres,
Canada, 1976/1977 to 1999/2000 .................................................. 66
Figure 50
Distribution of Hospital Expenditure by Type of Expense, Canada ......... 71
National Health Expenditure Trends 1975–2002
List of Figures (cont’d)
Figures 51–54 Share of Hospital Expenditure by Selected Types of Expenses, Canada,
1976/1977 to 1999/2000 .............................................................. 71
Figure 55
Distribution of Salaries and Benefits, Canada ..................................... 75
Figure 56
Distribution of Ambulatory Care Expenses, Canada ............................. 75
Figure 57
Distribution of Emergency Care Expenses, Canada.............................. 76
Figure 58
Share of Expenditure by Hospital Peer Group, Canada ......................... 77
Figure 59
Administrative Services as a Percent of Hospital Expenditure, Canada ... 82
Figure 60
Support Services as a Percent of Hospital Expenditure, Canada ............ 82
Figure 61
Ambulatory Care as a Percent of Hospital Expenditure, Canada ............ 83
Figure 62
Emergency Care as a Percent of Hospital Expenditure, Canada ............. 83
Figure 63
Composition of Total Health Expenditures, by Source of Finance .......... 94
National Health Expenditure Trends 1975–2002
List of Text Tables
Table 1
Distribution of Public Sector Health Expenditure by Source of Finance,
Canada, 1975 and 2000..................................................................... 11
Table 2
Quebec Drug Insurance Fund, 1997 to 2002 ......................................... 13
Table 3
Distribution of Private Sector Health Expenditure by Source of Finance,
Canada, 1988 and 2000..................................................................... 13
Table 4
Hospital Expenditure Summary by Sector of Finance, Canada, 2000......... 17
Table 5
Private Sector Health Expenditure, by Source of Finance and Use of
Funds, Canada, 2000 ......................................................................... 19
Table 6
Total Provincial/Territorial Government Health Expenditure Per Capita
Standardized for Age and Sex, by Province/Territory and Canada,
1998 to 2000 ................................................................................... 31
Table 7
Health Expenditure Summary, by Province/Territory and Canada, 2000..... 33
Table 8
Total Health Expenditure as a Percent of GDP for Selected Countries,
1975 to 2000 ................................................................................... 43
Table 9
Hospital Expenditure and the Percentage Distributions by Functional
Centre, Canada.................................................................................. 63
Table 10
Expenditure Weights and Annual Rates of Increase, Administrative and
Support Services, Canada ................................................................... 65
Table 11
Hospital Expenditures by Functional Centre and Type of Expense,
Canada, 1999 ................................................................................... 74
Table 12
Estimated Expenditure by Hospital Peer Group, Canada,
1995 and 1999 ................................................................................. 78
Table 13
Hospitals and Beds in Operation, Canada, 1995 and 1999 ...................... 78
Table 14
Distribution of Hospital Expenditure by Peer Group and Functional
Centre, Canada, 1999 ........................................................................ 79
Table 15
Differences from Previously Reported Provincial Government Sector Data
by Province/Territory and Canada, 1985 to 1998................................. 116
National Health Expenditure Trends 1975–2002
List of Text Tables (cont’d)
Table 16
Differences from Previously Reported Private Sector Data by
Province/Territory and Canada, 1991 to 1999 ..................................... 117
Table 17
Differences from Previously Reported Federal Direct Sector Data by
Province/Territory and Canada, 1988 to 1999 ..................................... 117
Table 18
Differences from Previously Reported Municipal Government Sector
Data by Province/Territory and Canada, 1980 to 1999 ......................... 118
Table 19
Differences from Previously Reported Social Security Fund Data
by Province/Territory and Canada, 1990 to 1999................................. 119
National Health Expenditure Trends 1975–2002
List of Data Tables
Series A—Summary Data, Canada
1
Total Health Expenditure, Canada, 1975 to 2002—Summary
2.1–.3
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002—
Current Dollars
2.4–.5
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002—
Constant Dollars
3.1.1–.3
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
3.2.1–.3
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
3.3.1–.3
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
Series B—Total Health Expenditure by Source of Finance,
by Province/Territory and Canada (Selected Tables)
1.1–.2
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
1.3
Total Health Expenditure as a Percent of (Provincial/Territorial) G.D.P.,
1975 to 2002—Current Dollars
2.1–.2
Private Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
2.3
Private Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002—Current Dollars
3.1–.2
Public Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
3.3
Public Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002—Current Dollars
4.1–.2
Provincial/Territorial Government Sector Health Expenditure, by
Province/Territory and Canada, 1975 to 2002—Current Dollars
4.3
Provincial/Territorial Government Sector Health Expenditure as a Proportion of
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables
Series E—Provincial Government Health Expenditure by Selected Uses of Funds,
by Age and Sex, by Province/Territory and Canada (Selected Tables)
1.1-.3
Estimate of Total Provincial Government Health Expenditure by Age and Sex,
by Province/Territory and Canada, 1998 to 2000—Current Dollars
List of Data Tables on CD-ROM
Series A—Summary Data, Canada
1
Total Health Expenditure, Canada, 1975 to 2002—Summary
2.1–.3
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002—
Current Dollars
2.4–.5
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002—
Constant Dollars
3.1.1–.3
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
3.2.1–.3
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
3.3.1–.3
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
Series B—Total Health Expenditure by Source of Finance,
by Province/Territory and Canada
1.1–.2
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
1.3
Total Health Expenditure as a Percent of (Provincial/Territorial) G.D.P.,
1975 to 2002—Current Dollars
1.4–.5
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Constant Dollars
2.1–.2
Private Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
2.3
Private Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002—Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series B—Total Health Expenditure by Source of Finance,
by Province/Territory and Canada (cont’d)
2.4–.5
Private Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
3.1–.2
Public Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
3.3
Public Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002—Current Dollars
3.4–.5
Public Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
4.1–.2
Provincial/Territorial Government Sector Health Expenditure, by
Province/Territory and Canada, 1975 to 2002—Current Dollars
4.3
Provincial/Territorial Government Sector Health Expenditure as a Proportion of
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
4.4
Total Provincial/Territorial Government Sector Health Expenditure as a
Proportion of Total Provincial Government Programs, by Province/Territory and
Canada, 1975 to 2001—Current Dollars
4.5
Total Provincial/Territorial Government Sector Health Expenditure as a
Proportion of Total Provincial Government Expenditures, by Province/Territory
and Canada, 1975 to 2001—Current Dollars
4.6–.7
Provincial/Territorial Government Sector Health Expenditure, by
Province/Territory and Canada, 1975 to 2002—Constant Dollars
5.1–.2
Other Public Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
5.3
Other Public Sector Health Expenditure as a Proportion of Total Health
Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
5.4–.5
Other Public Sector Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
6.1–.2
Federal Direct Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
6.3
Federal Direct Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002—Current Dollars
6.4–.5
Federal Direct Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series B—Total Health Expenditure by Source of Finance,
by Province/Territory and Canada (cont’d)
7.1–.2
Municipal Government Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
7.3
Municipal Government Health Expenditure as a Proportion of Total
Health Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
7.4–.5
Municipal Government Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
8.1–.2
Social Security Funds Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Current Dollars
8.3
Social Security Funds Health Expenditure as a Proportion of Total Health
Expenditure, by Province/Territory and Canada, 1975 to 2002—
Current Dollars
8 .4–.5
Social Security Funds Health Expenditure, by Province/Territory and Canada,
1975 to 2002—Constant Dollars
Series C—Health Expenditure by Use of Funds, by Source of Finance, Canada
1.1–.3
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
1.4
Public and Private Share of Total Health Expenditure by Use of Funds, Canada,
1975 to 2002—Current Dollars
2.1–.3
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
2.4
Private Sector Health Expenditure, by Use of Funds, as a Percent of Total,
Canada, 1975 to 2002—Current Dollars
3.1–.3
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
3.4
Public Sector Health Expenditure, by Use of Funds, as a Percent of Total,
Canada, 1975 to 2002—Current Dollars
4.1–.3
Provincial/Territorial Government Sector Health Expenditure by Use of Funds,
Canada, 1975 to 2002—Current Dollars
4.4
Provincial/Territorial Government Sector Health Expenditure, by Use of Funds,
as a Percent of Total, Canada, 1975 to 2002—Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series C—Health Expenditure by Use of Funds, by Source of Finance,
Canada (cont’d)
5.1–.3
Other Public Sector Health Expenditure by Use of Funds, Canada, 1975 to
2002—Current Dollars
5.4
Other Public Sector Health Expenditure, by Use of Funds, as a Percent of Total,
Canada, 1975 to 2002—Current Dollars
6.1–.3
Federal Direct Health Expenditure by Use of Funds, Canada, 1975 to 2002—
Current Dollars
6.4
Federal Direct Health Expenditure, by Use of Funds, as a Percent of Total,
Canada, 1975 to 2002—Current Dollars
7.1–.3
Municipal Government Health Expenditure by Use of Funds, Canada,
1975 to 2002—Current Dollars
7.4
Municipal Government Health Expenditure, by Use of Funds, as a Percent of
Total, Canada, 1975 to 2002—Current Dollars
8.1–.3
Social Security Funds Health Expenditure by Use of Funds, Canada,
1975 to 2002—Current Dollars
8.4
Social Security Funds Health Expenditure, by Use of Funds, as a Percent of
Total, Canada, 1975 to 2002—Current Dollars
Series D—Health Expenditure by Use of Funds, by Source of Finance,
by Province/Territory
Series D1—Total Health Expenditure by Use of Funds, by Province/Territory
1.1.1–.3
Total Health Expenditure by Use of Funds, Newfoundland, 1975 to 2002—
Current Dollars
1.2.1–.3
Total Health Expenditure by Use of Funds, Prince Edward Island,
1975 to 2002—Current Dollars
1.3.1–.3
Total Health Expenditure by Use of Funds, Nova Scotia, 1975 to 2002—
Current Dollars
1.4.1–.3
Total Health Expenditure by Use of Funds, New Brunswick, 1975 to 2002—
Current Dollars
1.5.1–.3
Total Health Expenditure by Use of Funds, Quebec, 1975 to 2002—
Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series D1—Total Health Expenditure by Use of Funds, by Province/Territory (cont’d)
1.6.1–.3
Total Health Expenditure by Use of Funds, Ontario, 1975 to 2002—
Current Dollars
1.7.1–.3
Total Health Expenditure by Use of Funds, Manitoba, 1975 to 2002—
Current Dollars
1.8.1–.3
Total Health Expenditure by Use of Funds, Saskatchewan, 1975 to 2002—
Current Dollars
1.9.1–.3
Total Health Expenditure by Use of Funds, Alberta, 1975 to 2002—
Current Dollars
1.10.1–.3 Total Health Expenditure by Use of Funds, British Columbia, 1975 to 2002—
Current Dollars
1.11.1–.3 Total Health Expenditure by Use of Funds, Yukon Territory, 1975 to 2002—
Current Dollars
1.12.1–.3 Total Health Expenditure by Use of Funds, Northwest Territories,
1975 to 2002—Current Dollars
1.13.1–.3 Total Health Expenditure by Use of Funds, Nunavut Territory, 1975 to 2002—
Current Dollars
Series D2—Private Sector Health Expenditure by Use of Funds, by Province/Territory
2.1.1–.3
Private Sector Health Expenditure by Use of Funds, Newfoundland,
1975 to 2002—Current Dollars
2.2.1–.3
Private Sector Health Expenditure by Use of Funds, Prince Edward Island,
1975 to 2002—Current Dollars
2.3.1–.3
Private Sector Health Expenditure by Use of Funds, Nova Scotia,
1975 to 2002—Current Dollars
2.4.1–.3
Private Sector Health Expenditure by Use of Funds, New Brunswick,
1975 to 2002—Current Dollars
2.5.1–.3
Private Sector Health Expenditure by Use of Funds, Quebec, 1975 to 2002—
Current Dollars
2.6.1–.3
Private Sector Health Expenditure by Use of Funds, Ontario, 1975 to 2002—
Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series D2—Private Sector Health Expenditure by Use of Funds,
by Province/Territory (cont’d)
2.7.1–.3
Private Sector Health Expenditure by Use of Funds, Manitoba, 1975 to 2002—
Current Dollars
2.8.1–.3
Private Sector Health Expenditure by Use of Funds, Saskatchewan,
1975 to 2002—Current Dollars
2.9.1–.3
Private Sector Health Expenditure by Use of Funds, Alberta, 1975 to 2002—
Current Dollars
2.10.1–.3 Private Sector Health Expenditure by Use of Funds, British Columbia,
1975 to 2002—Current Dollars
2.11.1–.3 Private Sector Health Expenditure by Use of Funds, Yukon Territory,
1975 to 2002—Current Dollars
2.12.1–.3 Private Sector Health Expenditure by Use of Funds, Northwest Territories, 1975
to 2002—Current Dollars
2.13.1–.3 Private Sector Health Expenditure by Use of Funds, Nunavut Territory,
1975 to 2002—Current Dollars
Series D3—Public Sector Health Expenditure by Use of Funds, by Province/Territory
3.1.1–.3
Public Sector Health Expenditure by Use of Funds, Newfoundland,
1975 to 2002—Current Dollars
3.2.1–.3
Public Sector Health Expenditure by Use of Funds, Prince Edward Island,
1975 to 2002—Current Dollars
3.3.1–.3
Public Sector Health Expenditure by Use of Funds, Nova Scotia,
1975 to 2002—Current Dollars
3.4.1–.3
Public Sector Health Expenditure by Use of Funds, New Brunswick,
1975 to 2002—Current Dollars
3.5.1–.3
Public Sector Health Expenditure by Use of Funds, Quebec, 1975 to 2002—
Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series D3—Public Sector Health Expenditure by Use of Funds,
by Province/Territory (cont’d)
3.6.1–.3
Public Sector Health Expenditure by Use of Funds, Ontario, 1975 to 2002—
Current Dollars
3.7.1–.3
Public Sector Health Expenditure by Use of Funds, Manitoba, 1975 to 2002—
Current Dollars
3.8.1–.3
Public Sector Health Expenditure by Use of Funds, Saskatchewan,
1975 to 2002—Current Dollars
3.9.1–.3
Public Sector Health Expenditure by Use of Funds, Alberta, 1975 to 2002—
Current Dollars
3.10.1–.3 Public Sector Health Expenditure by Use of Funds, British Columbia,
1975 to 2002—Current Dollars
3.11.1–.3 Public Sector Health Expenditure by Use of Funds, Yukon Territory,
1975 to 2002—Current Dollars
3.12.1–.3 Public Sector Health Expenditure by Use of Funds, Northwest Territories,
1975 to 2002—Current Dollars
3.13.1–.3 Public Sector Health Expenditure by Use of Funds, Nunavut Territory,
1975 to 2002—Current Dollars
Series D4—Provincial/Territorial Government Health Expenditure by Use of Funds,
by Province/Territory
4.1.1–.3
Provincial Government Health Expenditure by Use of Funds, Newfoundland,
1975 to 2002—Current Dollars
4.2.1–.3
Provincial Government Health Expenditure by Use of Funds, Prince Edward
Island, 1975 to 2002—Current Dollars
4.3.1–.3
Provincial Government Health Expenditure by Use of Funds, Nova Scotia,
1975 to 2002—Current Dollars
4.4.1–.3
Provincial Government Health Expenditure by Use of Funds, New Brunswick,
1975 to 2002—Current Dollars
4.5.1–.3
Provincial Government Health Expenditure by Use of Funds, Quebec,
1975 to 2002—Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series D4—Provincial/Territorial Government Health Expenditure by Use of Funds,
by Province/Territory (cont’d)
4.6.1–.3
Provincial Government Health Expenditure by Use of Funds, Ontario,
1975 to 2002—Current Dollars
4.7.1–.3
Provincial Government Health Expenditure by Use of Funds, Manitoba,
1975 to 2002—Current Dollars
4.8.1–.3
Provincial Government Health Expenditure by Use of Funds, Saskatchewan,
1975 to 2002—Current Dollars
4.9.1–.3
Provincial Government Health Expenditure by Use of Funds, Alberta,
1975 to 2002—Current Dollars
4.10.1–.3 Provincial Government Health Expenditure by Use of Funds, British Columbia,
1975 to 2002—Current Dollars
4.11.1–.3 Territorial Government Health Expenditure by Use of Funds, Yukon Territory,
1975 to 2002—Current Dollars
4.12.1–.3 Territorial Government Health Expenditure by Use of Funds, Northwest
Territories, 1975 to 2002—Current Dollars
4.13.1–.3 Territorial Government Health Expenditure by Use of Funds, Nunavut Territory,
1975 to 2002—Current Dollars
Series E—Provincial Government Health Expenditure by Selected Uses of Funds,
by Age and Sex, by Province/Territory and Canada
1.1-.3
Estimate of Total Provincial Government Health Expenditure by Age and Sex,
by Province/Territory and Canada, 1998 to 2000—Current Dollars
2.1–.5
Provincial/Territorial Government Hospital Expenditure by Age and Sex,
by Province/Territory and Canada, 1996 to 2000—Current Dollars
3.1–.5
Provincial/Territorial Government Other Institutions Expenditure by Age and
Sex, by Province/Territory and Canada, 1996 to 2000—Current Dollars
4.1-.5
Provincial/Territorial Government Physicians Expenditure by Age and Sex,
by Province/Territory and Canada, 1996 to 2000—Current Dollars
5.1-.5
Provincial/Territorial Government Other Professionals Expenditure by Age and
Sex, by Province/Territory and Canada, 1996 to 2000—Current Dollars
6.1-.5
Provincial/Territorial Government Drugs Expenditure by Age and Sex, by
Province/Territory and Canada, 1996 to 2000—Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series F—Provincial/Territorial Government Health Expenditure,
by Province/Territory and Canada
1.1.1 - .2 Provincial/Territorial Government Health Expenditure, by Province/Territory and
Canada, 1974/1975 to 2002/2003—Current Dollars
1.1.3
Total Provincial/Territorial Government Health Expenditure as a Percent
of (Provincial/Territorial) G.D.P., by Province/Territory and Canada, 1974/1975
to 2002/2003—Current Dollars
1.1.4
Total Provincial/Territorial Government Health Expenditure as a Proportion of
Total Provincial Government Programs, by Province/Territory and Canada,
1974/1975 to 2001/2002—Current Dollars
1.1.5
Total Provincial/Territorial Government Health Expenditure as a Proportion of
Total Provincial Government Expenditures, by Province/Territory and Canada,
1974/1975 to 2001/2002—Current Dollars
1.1.6 –.7 Provincial/Territorial Government Health Expenditure, by Province/Territory and
Canada, 1975/1976 to 2002/2003—Constant Dollars
2.1.1 –.3 Provincial/Territorial Government Health Expenditure, by Use of Funds, Canada,
1974/1975 to 2002/2003—Current Dollars
3.1.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Newfoundland,
1974/1975 to 2002/2003—Current Dollars
3.2.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Prince Edward
Island, 1974/1975 to 2002/2003—Current Dollars
3.3.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Nova Scotia,
1974/1975 to 2002/2003—Current Dollars
3.4.1 –.3 Provincial Government Health Expenditure, by Use of Funds, New Brunswick,
1974/1975 to 2002/2003—Current Dollars
3.5.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Quebec,
1974/1975 to 2002/2003—Current Dollars
3.6.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Ontario,
1974/1975 to 2002/2003—Current Dollars
3.7.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Manitoba,
1974/1975 to 2002/2003—Current Dollars
3.8.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Saskatchewan,
1974/1975 to 2002/2003—Current Dollars
3.9.1 –.3 Provincial Government Health Expenditure, by Use of Funds, Alberta,
1974/1975 to 2002/2003—Current Dollars
National Health Expenditure Trends 1975–2002
List of Data Tables on CD-ROM (cont’d)
Series F—Provincial/Territorial Government Health Expenditure,
by Province/Territory and Canada (cont’d)
3.10.1 –.3 Provincial Government Health Expenditure, by Use of Funds, British Columbia,
1974/1975 to 2002/2003—Current Dollars
3.11.1 –.3 Territorial Government Health Expenditure, by Use of Funds, Yukon Territory,
1974/1975 to 2002/2003—Current Dollars
3.12.1 –.3 Territorial Government Health Expenditure, by Use of Funds, Northwest
Territories, 1974/1975 to 2002/2003—Current Dollars
3.13.1 –.3 Territorial Government Health Expenditure, by Use of Funds, Nunavut Territory,
1974/1975 to 2002/2003—Current Dollars
Series G—Hospital Expenditure by Functional Centre and Type of Expense—
Fiscal Year 1976/1977 to 1999/2000, Canada
Appendices A–D
Appendix A.1—Gross Domestic Product
Appendix B.1-.3—Implicit Price Indices
Appendix C.1-.6—Population by Province/Territory, Canada
Appendix D.1-.2—Total Provincial/Territorial Government Programs/Expenditures,
by Province/Territory, Canada
Acknowledgments
It is only through the contribution of many individuals and organizations that the production
of National Health Expenditure Trends, 1975–2002, is possible. The Canadian Institute for
Health Information (CIHI) expresses its gratitude to:
The National Health Expenditure Expert Advisory Group for their advice and constructive
comments related to National Health Expenditures:

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



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
Dr. John Horne, Health Sciences Centre, Winnipeg, Manitoba
Dr. Richard Plain, University of Alberta
Dr. Robert G. Evans, University of British Columbia
M. André Grenon, Health Canada
Dr. Michael Wolfson, Statistics Canada
Dr. Jeremiah Hurley, McMaster University
Dr. Stephen Law, Mount Allison University
M. Jean Houde, Ministère de la santé et des services sociaux du Québec
Mr. Cliff Halliwell, Health Canada
Ms. Louise Ogilvie, Canadian Institute for Health Information
Data Suppliers for their provision of data to the national health expenditure database:






Health Canada, Statistics Canada and other federal departments reporting health care
financial data
the provincial and territorial governments
the provincial and territorial Workers’ Compensation Boards and la Commission de la
santé et de la sécurité du travail du Québec
A.C. Nielsen Canada
the insurance industry, whose participation has enhanced our understanding of
expenditures in the private sector:
− The Canadian Life and Health Insurance Association Inc.
− Atlantic Blue Cross Care
− Croix Bleue du Québec
− CUMBA
− Greenshield Canada
− Liberty Health
− Manitoba Blue Cross (United Health Services Corporation)
− Saskatchewan Blue Cross Medical Services Incorporated
− Saskatchewan Group Medical Services
− Alberta Blue Cross
− Pacific Blue Cross
Association of Canadian Medical Colleges
i

Provincial and territorial ministries for providing age and sex distributions for their
respective drug subsidy and additional health benefit programs:
− Newfoundland Medical Services Commission
− Maritime Medical Care facilitated by the Nova Scotia Department of Health, Insured
Programs Management and Clinical Rationalization
− Atlantic Blue Cross Care facilitated by the New Brunswick Department of Health and
Community Services, Medicare/Prescription Drug Program
− Régie de l’assurance-maladie du Québec facilitated by the Quebec Ministry of Health
and Social Services
− Ontario Ministry of Health and Long-Term Care, Ontario Health Insurance Program
and Drug Programs Branch
− Manitoba Health and Ministry of Family Services, Employment and Income
Assistance Division
− Saskatchewan Health, Saskatchewan Drug Plan and Extended Benefits Branch and
Saskatchewan Medical Services Branch
− Alberta Blue Cross facilitated by Alberta Health and Wellness and Alberta Human
Resources and Employment. Alberta Health and Wellness Extended Health Benefits
− British Columbia Ministry of Health Services, Medical Services Plan and Pharmacare
Planning and Special Projects
− Yukon Department of Health and Social Services
− Northwest Territories Department of Health and Social Services
External Consultants to CIHI for their technical expertise and assistance:
!
Vern Hicks, Health Economics Consulting Services
!
Richard Trudeau, Statistics Canada
!
Rob Dunphy, Statistics Canada
CIHI is responsible for the National Health Expenditure (NHEX) Database. The dedicated
work of its NHEX section, Geoff Ballinger, Ian Button, Terry Campbell, Gilles Fortin, Chad
Gyorfi-Dyke, and Jingbo Zhang is essential to the classification and dissemination of data
that describe Canadian health expenditure. The NHEX section would also like to thank
colleagues from the Canadian MIS Database, particularly Greg Zinck and Erik Markhauser
for their technical expertise and assistance on the Analytical Focus of this report.
ii
NATIONAL HEALTH EXPENDITURE TRENDS H I G H L I G H T S
Highlights

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

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

1
Total health expenditure, in current dollars1, was estimated at $97.4 billion in 2000,
and is forecast to have reached $105.6 billion in 2001 and $112.2 billion
in 2002.
After adjusting for inflation the health care spending grew at an average annual rate
of 3.8% between 1975 and 1991, from 1991 to 1996 total spending on health
care declined by 0.8%. It increased to 5.2% from 1996 to 2000. Real growth is
expected to have been 6.6% in 2001 and 3.3% in 2002.
Total health expenditure per capita was estimated at $3,164 in 2000 and is
expected to have been $3,395 in 2001 and $3,572 in 2002.
Total health care spending as a percentage of Gross Domestic Product was 9.1% in
2000; the ratio is forecast to have increased to 9.7% in 2001 and is expected to
have been 9.8% in 2002.
In 1998, for the first time since 1991, public sector health expenditure grew faster
than private sector expenditure. Consequently, the private sector share fell from its
peak in 1997 of 30.0% to 29.2% in 2000. It is expected to remain at 29.2% in
2001 and increase slightly to 29.3% of total expenditure in 2002.
The category of drugs ranks second after hospitals in terms of its share of total
health expenditure. In 1997, expenditure on drugs overtook spending on physicians’
services. The share of total spending accounted for by drugs grew from a low of
8.4% in the late 1970s to 15.4% in 2000. In 2002, drugs are expected to remain
ranked second with a share of 16.2%.
Total health expenditure per capita varies among the provinces. In 2000, Manitoba
and Ontario spent more per person on health care than any other province, at
$3,500 and $3,312, respectively. Prince Edward Island, followed by Quebec, had
the lowest expenditure per capita at $2,863 and 2,870, respectively.
Health expenditure varies considerably among different age and sex groups. After
adjusting for differences in provincial age and sex distributions, Newfoundland,
Alberta and Manitoba had the highest per capita provincial government expenditure
in 2000, while Prince Edward Island and Nova Scotia had the lowest.
According to a new analysis appearing in the Analytical Focus of this report, there
has been a substantial reduction in the shares of hospital expenditure accounted for
by support services and nursing inpatient services since the mid-1970s. Furthermore,
the share allocated to administration has increased during the late 1990s.
All figures are in current dollars (unadjusted for inflation) unless otherwise stated.
iii
NATIONAL HEALTH EXPENDITURE TRENDS I N T R O D U C T I O N
Introduction
Both the public and private sectors finance Canada’s health system. Public sector funding
includes payments by governments at the federal, provincial/territorial and municipal levels
and by Workers’ Compensation Boards and other social security schemes. Private sector
funding consists primarily of health expenditures by households and private insurance firms.
The Canadian Institute for Health Information (CIHI) tracks health spending by each source
of finance in the National Health Expenditure Database (NHEX). This database contains a
historical series of macro level health expenditure statistics by province and territory
beginning in 1960. The Canadian Institute for Health Information assumed responsibility for
the national health accounts, including the National Health Expenditure database, in 1995.
National Health Expenditure Trends (1975–2002) is CIHI’s sixth annual health expenditure
trends publication and provides detailed updated information on health expenditure in
Canada. The 2002 report contains more information than previous versions. It has been
reorganized to make the information more accessible to both casual and comprehensive
users of the information. This publication includes:




Highlights of national health expenditure;
An overview that includes health expenditure trends from 1975 to 2002; 2000
figures which are now considered to be an estimate rather than a forecast; an outlook
for 2001 and 2002;
An update of provincial/territorial government health expenditure by age and sex
including three years of expenditure data standardized for age and sex; and
Updated data tables, which contain estimates to 2000 and forecasts to 2002.
Special features of this year’s publication are:




Summary level data tables appear at the end of the publication. Over 300 detailed
data tables in calendar and fiscal year are available in Microsoft® Excel© in the
CD-ROM affixed to the inside of the back cover of this document.
An Analyticical Focus presenting the initial results of a project to link data from CIHI’s
Canadian MIS Database (formerly the Annual Hospital Survey) and Statistics Canada’s
Annual Return of Health Care Facilities by hospital functional centre and type of
expense. The analysis is based on an historical series developed from the
two datasets from 1976/1977 to 1999/2000.
A summary of enhancements to the National Health Expenditure under the
Roadmap initiative.
Enhanced International Comparisons.
1
NATIONAL HEALTH EXPENDITURE TRENDS I N T R O D U C T I O N
In order to improve the quality of the data in the National Health Expenditure database, the
historical information appearing in earlier publications has been revised. A detailed
explanation of the revisions can be found in the Data Quality section under Major Changes
from Previous Years.
More information on health expenditures and the methods used in the preparation of this
document is available by contacting the NHEX section by telephone, (613) 241-7860 or
by e-mail: [email protected]
2
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Overview
T O T A L
H E A L T H
E X P E N D I T U R E
# 2000 and Outlook for 2001 and 2002
Total Health Expenditures in Canada were $97.4 billion in 2000. Expenditures are forecast
to have been $105.6 billion in 2001 and $112.2 billion in 2002, an increase of 8.4% and
6.3%, respectively. Real rates of increase at constant (1997) prices are 6.6% in 2001 and
3.3% in 2002.
($'billions)
Figure 1 - Total Health Expenditure, Canada,
1975 to 2002
120.0
100.0
Current
Constant ($1997)
Forecast
80.0
60.0
40.0
20.0
0.0
1975
78
81
84
87
90
93
96
99
2002
Year
Source: Canadian Institute for Health Information
# Trends—1975 to 2000
Health expenditure in 2000 continued the trend of relatively strong growth that has been
observed since 1997, following six years when annual growth rates averaged 0.8% in real
terms (Figure 1). The modest rates of growth during the early to mid-1990s reflected a
flattening of the historic growth curve. From 1975 to 1991 the annual average rate of
growth was 3.8% (Figure 2). The trend since 1997 appears to be largely due to
reinvestment by federal, provincial and territorial governments after a period of fiscal
restraint during the early and mid-1990s.
3
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 2 - Total Health Expenditure, Annual Growth Rates in
Constant 1997 Dollars, Canada, 1976 to 2002
6.0%
Actual
Forecast
4.0%
2.0%
0.0%
1976
78
80
82
84
86
88
90
Year
92
94
96
98
00
2002
Source: Canadian Institute for Health Information
T O T A L
H E A L T H
E X P E N D I T U R E
P E R
C A P I T A
# 2000 and Outlook for 2001 and 2002
Total Health Expenditure per capita was $3,164 in 2000. Forecasts for 2001 and 2002 are
expected to have been $3,395 and $3,572 (Figure 3). After adjusting for inflation, real rates
of increase in 2001 and 2002 are expected to have been 5.5% and 2.3%, respectively.
Figure 3 - Total Health Expenditure Per Capita, Canada,
1975 to 2002
$3,500
$3,000
$2,500
Current
Constant ($1997)
Forecast
$2,000
$1,500
$1,000
$500
$0
1975
78
81
84
87
Source: Canadian Institute for Health Information
90
Year
4
93
96
99
2002
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Trends—1975 to 2000
Total health expenditure per capita in constant (1997) dollars, increased by an average
annual rate of 2.6% from 1975 to 1991. From 1991 to 1996 expenditure per capita
declined by an annual average rate of three-tenths of one percent per year (Figure 4).
Accelerating growth rates during the next four years, when the average increase was
4.2% per year, followed this decline.
Figure 4 - Total Health Expenditure Per Capita, Annual Growth
Rates in Constant 1997 Dollars, Canada, 1976 to 2002
5.0%
Actual
Forecast
3.0%
1.0%
1976
-1.0%
78
80
82
84
86
88
Source: Canadian Institute for Health Information
90
92
94
96
98
00
2002
Year
T O T A L H E A L T H E X P E N D I T U R E
E C O N O M I C G R O W T H
A N D
# 2000 and Outlook for 2001 and 2002
Total health expenditure was 9.1% of Gross Domestic Product (GDP) in 2000. It is forecast
to have been 9.7% in 2001, reflecting relatively high real growth in total health expenditure
(6.6%) and lower real growth in the denominator, GDP (1.4%). The last time there was a
spread in the two growth rates above five percentage points was in 1991 during the last
recession. According to forecasts and despite a smaller spread in growth rates in 2002, the
ratio of total health expenditure to GDP is expected to rise to 9.8%, approaching the peak
last reached in 1992 (Figure 5).
5
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 5 - Total Health Expenditure as a Percentage of
Gross Domestic Product, Current Dollars, Canada,
1975 to 2002
10.0%
Actual
Forecast
9.0%
8.0%
7.0%
6.0%
1975
78
81
84
87
90
93
96
99
2002
Year
Sources: Canadian Institute for Health Information, Statistics Canada
# Trends—1975 to 2000
Total health expenditure, as a proportion of GDP was 7.0% in 1975. During the late 1970s,
total health expenditures increased at rates that were almost identical to the rate
of growth in GDP. The two rates of growth diverged during the early 1980s. Real GDP
fell during the 1982 recession, and did not recover to its pre-recession level until 1984
(Figure 6). Health expenditure continued to grow during this time. Consequently, the ratio
of total health expenditure to GDP increased sharply, from 6.8% in 1979 to 8.3% in 1983.
Real health expenditure grew at slightly higher rates than the economy during two of the
last 5 years of the 1980s. By the end of the decade, the total health expenditure to GDP
ratio was equivalent to 8.5%.
Figure 6 - Health Expenditure and GDP Trends, Constant Dollar
Indices (1975 = 100), Canada, 1975 to 2002
250
225
200
Health Care
GDP
Forecast
175
150
125
100
1975
78
81
84
87
90
93
Year
Sources: Canadian Institute for Health Information, Statistics Canada
6
96
99
2002
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Canada experienced another recession from 1990 until 1992. Real GDP increased in 1992
but did not recover to pre-recession levels until 1993. Real health expenditures grew at
higher rates than real GDP from 1989 to 1992. The ratio of total health expenditure to GDP
increased significantly during these four years reaching 10.0% for the first time in 1992.
Real health expenditures then grew more slowly than GDP between 1993 and 1997;
consequently, the health to GDP ratio fell each year in that period until it reached 8.9% in
1997. Real health expenditure has grown faster than GDP each year between 1998 and
2000, with the result that the health to GDP ratio reached 9.1% in 2000.
See Data Tables A.1 and B.1.3.
T O T A L H E A L T H
O F F I N A N C E
E X P E N D I T U R E
B Y
S O U R C E
# 2000 and Outlook for 2001 and 2002
In 2000, governments and government agencies in Canada (the public sector) spent
$69.0 billion. Public sector expenditure is forecast to have been $74.7 billion in 2001
and $79.4 billion in 2002. The growth rates associated with these increases are 8.4%
and 6.2%, respectively; reflecting increased spending by governments on health. In 2000,
private health insurers and households (the private sector) spent $28.4 billion. Private
sector expenditure is forecast to have reached $30.9 billion in 2001 and $32.9 billion in
2002, assuming growth rates of 8.5% and 6.5%, respectively.
In terms of constant (1997) dollars, the public sector spent $65.9 billion in 2000 and is
forecast to have spent $70.6 billion in 2001 and $72.6 billion in 2002, with respective
growth rates of 7.1% and 2.8%. Private sector expenditure was $26.6 billion in 2000 and
is forecast to have reached $28.1 billion in 2001 and $29.4 billion in 2002, with growth
rates of 5.5% and 4.5%, respectively.
The private sector accounted for 29.2% of total expenditure in 2000 and 2001. It is
expected to account for 29.3% in 2002.
# Trends—1975 to 2000
The average annual rate of growth in public sector health expenditure between 1975 and
1991 was 11.0%. There was a pronounced change in public expenditure trends following
the 1990–1992 recession (Figure 7). During this period, governments introduced fiscal
restraint measures, which affected spending for health and social programs. Average annual
rates of growth fell to 0.6% from 1992 to 1996, lower than at any time in the past 20
years. In 1995 and 1996 there was virtually no growth and in 1997 public sector
expenditure increased by 4.1%.
7
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 7 - Health Expenditure by Source of Finance, Canada,
1975 to 2002
($' billions)
80.0
Public Sector
60.0
Private Sector
Forecast
40.0
20.0
0.0
1975
78
81
84
87
90
93
96
99
2002
Year
Source: Canadian Institute for Health Information
By comparison, the average annual rate of growth of health spending by private health
insurers and households (the private sector) was 11.7% from 1975 to 1991. From 1992 to
1996, it was 4.9%. Private sector growth rates were considerably higher than the public
sector rates during this period and, as a result, the private sector share of total health
expenditure increased by 4.1 percentage points during the five years, reaching 30.0%
by 1997.
1998 marked the first year in which public sector growth was higher than growth in the
private sector by three or more percentage points since 1983. In 1998, public sector
health expenditure grew by 7.3% over the previous year reaching $59.1 billion. Private
sector growth in 1998 was 4.3%, adding $1.0 billion to private sector expenditure to
become $24.6 billion. In 1999, public sector expenditure grew by another 7.0% to reach
$63.2 billion. The private sector expenditure grew by 8.2%, more than the public sector
expenditure to become $26.6 billion. The higher growth in public sector health care
spending relative to the private sector resulted in a fall in the proportion that private sector
spending contributes to overall spending. In 1998 the private sector share fell to 29.4% of
total health expenditure; in 1999 it grew to 29.6% and in 2000 it fell by four-tenths of one
percentage point to 29.2%.
In terms of constant dollars, private sector expenditure grew more rapidly than public sector
expenditure during the last half of the 1970s (Figure 8). During this time, real growth rates
in the private sector averaged 5.1% annually, while public sector expenditure grew at real
rates of 2.7% annually. Rates converged in the early 1980s. From 1984 to 1990, the real
annual growth rates were almost identical in the two sectors, averaging 4.1% in the private
sector and 4.0% in the public sector.
8
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 8 - Health Expenditure by Source of Finance, Constant
Dollar Indices (1975 = 100), Canada,
1975 to 2002
300
275
250
Public
Private
Forecast
225
200
175
150
125
100
1975
78
81
84
87
90
93
96
99
2002
Year
Source: Canadian Institute for Health Information
Public sector expenditure continued to increase during the first two years of the
1990–1992 recession, at annual real rates averaging 3.0%. In 1992, however, the real
growth rate of public sector expenditure fell to 1.6%. In 1993, there was a decline in public
sector expenditure of seven tenths of one percent with further declines over the next 3
years. In 1997, expenditure increased by 2.9%. In 1998, 1999 and 2000 real growth in the
public sector increased by 6.2% each year, respectively, the highest real rates of public
sector growth to this point in time in the series.
During the six years after 1991, private expenditure continued to have real growth rates
averaging 3.8% per year. The different trends in private and public expenditures after 1991
explain in large part the rapid growth of the private sector share to 1997. By 1998,
however, the situation was reversed; real growth in the private sector was lower than in the
public sector at just 2.1%; and again in 1999 when it was 5.7%. In 1999, the private share
increased to 29.6% reflecting higher nominal growth in the private sector, however,
inflation was higher in the private sector that year, with the result that real growth was
higher in the public sector. In 2000, both nominal and real growth was lower in the private
sector and the private share fell to 29.2% (Figure 9).
9
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 9 - Growth in Real Per Capita Public and Private Health
Expenditure and the Private Share, Canada, 1976 to 2002
(Growth)
Private Sector Growth
Public Sector Growth
Private Share (Private Share)
6.0%
30.0%
5.0%
4.0%
28.0%
3.0%
26.0%
2.0%
1.0%
24.0%
0.0%
-1.0%
1976 78
80
82
84
86
88
90
Year
92
94
96
98
-2.0%
Sources: Canadian Institute for Health Information, Statistics Canada
00 2002 22.0%
20.0%
See Data Tables A.2.1, A.2.2, A.2.4, and A.2.5.
# Public Sector Health Expenditure by Source of Finance
Health expenditures by governments and government agencies (the public sector) are
financed by three levels of government—provincial and territorial governments; federal
government direct health care spending; municipal government and, by Workers'
Compensation Boards and other social security schemes. The distribution of public sector
expenditure among these four sources of finance is shown in Table 1. Provincial
government expenditure was $8.7 billion in 1975, accounting for 93.6% of public sector
expenditure and 71.4% of total expenditure that year. The other public sources together
totaled $0.6 billion, or 6.4% of the public sector and 4.8% of total expenditure in 1975.
The provincial/territorial government share of public sector spending was highest in the late
seventies at 94.1%. Over the next sixteen years, the proportion fell by 2.1 percentage
points to reach 92.9% of public spending in 1996. The proportion declined further in 1997,
when the Quebec Drug Insurance Fund was introduced and included in the Social Security
Funds sector. Higher relative growth in direct health care spending by the federal
government also contributed to the fall in the overall share of provincial government
spending in the public sector. By 2000, provincial/territorial government expenditure was
$63.4 billion, accounting for 92.0% of public sector expenditure, a drop of 1.7 percentage
points from 1975 and 2.2 percentage points from its high in 1979.
Provincial government expenditure as a proportion of total expenditure has gradually fallen
from 71.4% in 1975 to its minimum of 64.7% in 1999, with the largest falls during the
severest period of cost containment by provincial/territorial governments from 1992 to
1996. The proportion increased in 2000 to 65.1% and is expected to remain at 65.2% in
2001 and 2002.
10
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 1—Distribution of Public Sector Health Expenditure by Source of Finance,
Canada, 1975 and 2000
Provincial/Territorial Governments
Federal Direct
Social Security Funds
Municipal Governments
1975
($' 000,000)
8,710.4
398.3
121.1
71.6
Total Expense
9,301.4
2000
(%)
($' 000,000)
93.6
63,425.8
4.3
3,551.0
1.3
1,354.9
0.8
645.8
(%)
92.0
5.1
2.0
0.9
100.0
100.0
68,977.5
Source: Canadian Institute for Health Information
Federal Transfers
National health expenditures are reported based on the principle of responsibility for
payment rather than on the source of the funds. It is for this reason that federal health
transfers to the provinces are included in the provincial government sector.
In April 1996 the Canada Health and Social Transfer (CHST) was introduced. The CHST is a
block fund to the provinces in support of health care, post secondary education, social
assistance and other social programs. Provinces can allocate the CHST to health and other
social programs according to their specific priorities. Nevertheless, the 1999 federal
government budget allocated an additional $11.5 billion dollars in cash transfers to the
provinces on an equal per capita basis over 5 years. The federal government designated this
money specifically for health care. Most of the funds ($8.0 billion) were to be in the form of
future-year increases in the CHST, with a $3.5 billion supplement available to the provinces
and territories beginning in 1999.
An additional $2.5 billion over four years beginning in 2000/2001 was allocated to the
CHST in the February 2000 federal budget to fund both post-secondary education
and health. The health accord signed by the federal and provincial governments on
September 11, 2000 further supplemented the CHST adding gradual annual increases
that will take the cash component of the CHST from $15.5 billion in 2000/2001 to
$21 billion by 2005/2006.
The September 2000 health accord added an additional $2.3 billion in transfers by the
federal government to be paid out over five years that was outside of the CHST
mechanism. Specifically, $500 million was allocated in 2000/2001 for health information
technology. Another $1.0 billion was allocated over two years beginning in 2000/2001 to
the Medical Equipment Fund, which is intended to help in the purchase of major medical
equipment such as magnetic resonance imaging units. A further $800 million was allocated
over 4 years beginning in 2001/2002 to the Health Transition Fund for Primary Care which
is intended to ease pressures in emergency rooms and reduce waiting times.
In addition, the 1999 federal budget allocated nearly $1.4 billion over four years for
investments in health information, research and prevention. Furthermore, the Federal Minister
of Finance in his June 19, 2002 speech to the House of Commons Standing Committee on
11
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Finance, indicated that the federal government is prepared to provide greater funding to
Medicare if such reforms are recommended in the final report of the Commission on the
Future of Health Care in Canada, chaired by former Saskatchewan Premier Roy Romanow.
The increases in federal transfers will be reflected primarily in increased expenditures by the
provincial and territorial governments during the next several years.
Direct Federal Health Expenditure
In 2000, nearly 30 federal government departments and agencies provided direct health
care services to Canadians worth $3.6 billion and accounting for 3.6% of total health
expenditure, less than its peak of 3.8%, the previous year. Forecasts indicate that the share
of federal direct spending will fall to 3.5% of total spending in 2001 and 2002.
Federal departments that had the largest shares of total federal direct health expenditure in
2000 were Health Canada, which funded 71%, the Department of Veterans Affairs (15%),
the Solicitor General of Canada (4%) and the Department of National Defense (3%). The
Canadian Institutes for Health Research, which is included under Health Canada, accounted
for 10% of total federal direct health expenditure.
Social Security Funds
Workers' Compensation Boards which were shown as a separate category in reports prior to
the 2000 report are now included under Social Security Funds together with the Quebec Drug
Insurance Fund. Both Workers' Compensation Boards and the Quebec Drug Insurance Fund
meet the conditions of Social Security Funds. Social Security Funds are financially
autonomous social insurance schemes that are imposed and controlled by a government
authority. They generally involve compulsory contributions by employees, employers or both,
and the government authority determines the terms on which benefits are paid to recipients.
Workers Compensation Boards operate under provincial and territorial statute and are
considered agencies of the provincial/territorial governments. They are financed through
compulsory contributions by employers who pay a percentage of their total payroll
depending on the accident experience of each category of employer.
On January 1, 1997 the Quebec Ministry of Health and Social Services, through the Régie
de l'assurance-maladie du Québec (RAMQ) introduced a universal drug program that covered
residents of the province who were not otherwise covered by the provincial program or by
private health insurance generally offered through employment. Drug claims for these
participants are paid from the Drug Insurance Fund. This fund is self-financed through the
compulsory payment of premiums generally by the self-employed and employees of
organizations that do not offer private drug insurance as a benefit of employment.
This component of the Quebec drug program is considered to be a social security scheme,
while the remaining portion of the program that is paid through the Quebec Ministry of
Health and Social Services is included as a provincial government expenditure.
Table 2 presents estimates from 1997 to 2002 and annual percent changes from 1998 of
the Quebec Drug Insurance Fund.
12
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 2—Quebec Drug Insurance Fund, 1997 to 2002
$' 000,000
Annual Percent Change (%)
1997
1998
1999
2000
2001
2002 f
172.0
218.2
264.0
332.3
367.7
400.1
---
26.8
21.0
25.9
10.7
8.8
f-Forecast
Source: Canadian Institute for Health Information
# Private Sector Health Expenditure by Source of Finance
Private sector expenditure in the National Health Accounts has three distinct components:
household out-of-pocket expenditure, commercial and not-for-profit insurance expenditure
and non-consumption expenditure.2 The distribution of private expenditure between these
three sources of finance is shown in Table 2. Out-of-pocket expenditure was estimated at
$15.2 billion in 2000, an increase of $7.8 billion over the last twelve years. In 1988, the
first year for which data at this level of detail was available, out-of-pocket expenditure
accounted for 58.1% of private sector expenditure. By 2000, the proportion dropped to
53.5% as expenditure by insurance firms grew more rapidly. The share of non-consumption
expenditure dropped from 12.7% to 8.0% during the same period (Table 3).
Table 3—Distribution of Private Sector Health Expenditure by Source of Finance,
Canada, 19883 and 2000
Source of Finance
1988
($' 000,000)
Household
(out-of-pocket)
Private Health Insurance
Non-Consumption
Total Expense
(%)
2000
($' 000,000)
(%)
7,435.3
3,734.2
1,625.9
58.1
29.2
12.7
15,205.3
10,951.4
2,285.8
53.5
38.5
8.0
12,795.4
100.0
28,442.5
100.0
Source: Canadian Institute for Health Information
2
3
Non-consumption expenditure includes a number of heterogeneous components, such as hospital non-patient revenue,
capital expenditures for privately owned facilities and health research.
Private sector data were revised following a methodology review in the early 1990s. The revised private sector data
incorporated information estimated directly from insurance, out-of-pocket and non-consumption sources for 1988 and
subsequent years. See the Definition of the Private Sector near the end of the publication, for further details.
13
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Insurance firms increased their share of private sector expenditure by over nine percentage
points during the eleven-year interval (1988–2000) and in 2000 were responsible for nearly
40% of private sector health expenditure. Insurance expenditure grew more rapidly than
out-of-pocket expenditure during the late 1980s and most of the 1990s, but rates of
growth converged in the mid-1990s. By 1999, growth in health expenditure from
households and health insurance firms were similar at 5.3% and 11.5%, respectively
(Figure 10). This represents a fall in growth from the previous year in household expenditure
and an increase in insurance expenditure.
Figure 10 - Private Sector Health Expenditure, Annual Growth
of Selected Sources of Finance, Canada, 1989 to 2000
17.0%
14.0%
Out-of-Pocket
Insurance
11.0%
8.0%
5.0%
2.0%
1989
90
91
92
93
94
95
Year
Source: Canadian Institute for Health Information
14
96
97
98
99
2000
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
T O T A L H E A L T H
O F F U N D S
E X P E N D I T U R E
B Y
U S E
Health dollars are used to purchase health care goods and services, to provide capital
investment, to administer public and private insurance plans and public health programs,
and to fund research. These uses are grouped into eight major categories (uses of funds)
throughout most of the National Health Expenditure data series (Figure 11). Data table
series A.3.1 to A.3.3 report national estimates for thirteen categories.
Figure 11 - Total Health Expenditure by Use of Funds,
Canada, 2000
($' billions)
Hospitals
$31.2; 32.1%
Capital
Drugs
$15.1; 15.4%
$3.5; 3.6%
Public Health & Admin.
$5.8; 6.0%
Other Health Spending
$8.1; 8.3%
Physicians
$13.0; 13.3%
Other
Institutions
Other Professionals
$9.1; 9.4%
$11.6; 11.9%
Source: Canadian Institute for Health Information
This section discusses the public and private shares of total health expenditure and the
shares of the major categories between the public and private sectors and refers to
Figures 11 to 18.
Figure 12 shows national expenditures for the three major uses of funds from 1975 to
2002 in billions of current dollars. Figure 13 presents the public and private shares at the
national level of the eight major uses of funds in 2000.
See Data Tables A.3.1 to A.3.3 and C.1.1. to C.4.4.
15
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 12 - Total Health Expenditure, Selected Uses of Funds,
Canada, 1975 to 2002 - Current Dollars
($' billions)
35.0
30.0
25.0
20.0
Hospitals
Physicians
Drugs
Forecast
15.0
10.0
5.0
0.0
1975
78
81
84
87
90
Year
93
96
99
2002
Source: Canadian Institute for Health Information
Figure 13 - Public and Private Shares of Total Health
Expenditure, by Use of Funds, Canada, 2000
100.0%
80.0%
89.3%
72.5%
Public Sector Share
Private Sector Share
60.0%
40.0%
20.0%
100.0%
98.6%
91.3%
0.0%
Hospitals
68.8%
64.8%
35.2%
27.5%
8.7%
88.3%
31.2%
29.2%
11.7%
10.7%
1.4%
Other
Physicians
Institutions
70.8%
0.0%
Other
Professionals
Drugs
Source: Canadian Institute for Health Information
Capital
Public
Health &
Admin.
Other
Health
Spending
Average
# Hospitals
Hospitals have traditionally occupied a prominent place in health care provision. In the mid1970s hospitals accounted for approximately 45% of total health expenditure and for 56%
of provincial government health expenditure. During the past 28 years, the share of
hospitals in total health expenditure has fallen. Between 1976 and 1990, hospitals' share of
total expenditure fell by 6.2 percentage points, while their share of provincial expenditure
dropped 7.3 percentage points. During the 1990s hospitals' share of total and provincial
expenditure declined by 7.0 percentage points and 5.0 percentage points respectively
(Figure 14). At the end of the decade, Canadians spent $31.2 billion on hospitals,
accounting for 32.1% of total expenditure.
16
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
60.0%
Figure 14 - Hospitals' Share of Total Provincial Government
Health Expenditure and Total Health Expenditure, Canada,
1975 to 2002
Provincial Government Health Expenditure
Total Health Expenditure
Forecast
55.0%
50.0%
45.0%
40.0%
35.0%
30.0%
1975
78
81
84
87
Year
90
93
96
99
2002
Source: Canadian Institute for Health Information
Provincial and territorial government expenditure accounts for 90% of hospital income
(Table 4). The private sector is the next largest source of income, followed by other public
sectors. Private sector expenditure per capita decreased in most years from 1993 to 1998.
This decrease in hospital revenue from the private sector was due in large measure to
reductions in the number of hospitals and beds, and the associated decline in revenue
for preferred accommodation and auxiliary services. Private sector revenue fell more
rapidly than overall hospital expenditure, with the result that by 2000 the private sector
accounted for only 8.7% of total hospital expenditure, down from a high of 10.1% in 1994
(Figure 15).
Table 4—Hospital Expenditure Summary by Sector of Finance, Canada, 2000
Total Expenditure (000,000)
Expenditure Per Capita
Share of Total
Provincial
Other Public
$28,057.1
$475.7
$911.22
$15.45
89.8%
1.5%
Source: Canadian Institute for Health Information
17
Private
$2,712.5
$88.10
8.7%
Total
$31,245.3
$1,014.76
100.0%
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 15 - Private Sector Hospital Expenditure, Canada,
1975 to 2000
11.0%
$100
10.0%
$80
9.0%
$60
8.0%
7.0%
Expenditure Per Capita
$40
6.0%
Percent of Total Hospital Expenditure
$20
5.0%
4.0%
$0
1975
1980
1985
1990
1995
2000
Year
Sources: Canadian Institute for Health Information, Statistics Canada
Of the $2.7 billion spent on hospital services by the private sector in 2000, households and
insurance firms together spent nearly $1.3 billion providing income to hospitals for patient
services4. Non-patient revenue earned from investments, food services, real estate, parking,
rentals, donations and other sources provided the remaining $1.4 billion of the private
sector in 2000. The distribution of expenditure financed by insurance, households (out-ofpocket expenditure) and Non-Consumption in 2000 is shown in Table 5.
In 2001, it is expected that the private share of total hospital expenditure will have risen
slightly to 8.9%, reflecting higher expected growth in the private sector at 8.7% and
reaching $2.9 billion expenditure on hospital services. Growth in the provincial government
sector for the same year is expected to be 5.7% reaching $29.6 billion. In 2002, hospital
expenditure in the provincial government sector is expected to have grown by an additional
6.3% to reach $31.5 billion in expenditure. Growth in the private sector in 2002 is
expected to have been 8.1% to reach $3.2 billion in spending. The relatively higher growth
in the private sector than in the provincial government sector is expected to push the
private sector share of total hospital spending to 9.1%. Overall, the share that hospitals will
take of total expenditure will fall from 32.1% in 2000 to 31.3% in 2001 and in 2002.
4
Income to hospitals for patient services includes charges for preferred accommodation, care of non-residents, chronic care
co-payments, uninsured services and other patient services.
18
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 5—Private Sector Health Expenditure, by Source of Finance
and Use of Funds, Canada, 2000
($’ millions)
Hospital Accommodation
Other Institutions
Physicians Care
Other Professionals
Dental Care
Vision Care
Other - Other Professionals
Drugs
Prescribed Drugs
Over-the-Counter Drugs
Personal Health Supplies
Capital
Other Health Spending
Prepayment Administration
Health Research
Other Health Care Goods
Other Health Care Services
Total Expense
Households Insurance
Non(Out-of-Pocket)
Consumption
576.8
709.0
1,426.7
2,512.0
174.2
4.4
Total
2,712.5
2,512.0
178.6
2,998.2
1,860.5
711.5
3,781.7
485.4
521.4
6,779.9
2,345.9
1,232.9
2,562.5
1,716.8
1,605.9
3,864.3
6,426.9
1,716.8
1,605.9
409.5
409.5
1,475.2
449.6
205.7
281.2
50.8
59.1
15,205.3 10,951.4
2,285.8
1,475.2
449.6
256.5
340.4
28,442.5
Source: Canadian Institute for Health Information
# Drugs
Retail sales5 of prescribed and non-prescribed drugs together constituted the second largest
category of health expenditure in 2000 at $15.1 billion, an increase of 11.6% over 1999.
Expenditure for drugs has increased more rapidly than total expenditure, with the result that
the share of total health expenditure allocated to drugs increased from (a low of)
8.4% in the late 1970s to 15.4% in 2000 (Figure 11). Spending on drugs is forecast
to have increased by another 11.9% in 2001 to $16.8 billion and by 7.7% in 2002 to
$18.1 billion, or 16.2% of total health care spending.
Non-prescribed drugs, which include over-the-counter drugs and personal health supplies,
amounted to 22.1% of total expenditure on drugs in 2000 (Figure 16).
5
The drug category does not include drugs dispensed in hospitals and generally in other institutions. These are included in the
categories of hospitals and other institutions.
19
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure
Figure 16
16 -- Drugs
Drugs by
by Source
Source of
of Finance
Finance and
and Type,
Type,
Canada,
2000
Canada, 2000
($'
($' billions)
billions)
Public
Public Sector
Sector
(Prescribed
(Prescribed
Drugs)
Drugs)
$5.3,
$5.3,
35.2%
35.2%
Prescribed
Prescribed
$6.4,
$6.4,
42.7%
42.7%
Private
Private Sector
Sector
(Prescribed
(Prescribed &
&
NonNonPrescribed
Prescribed
Drugs)
Drugs)
$9.7,
$9.7,
64.8%
64.8%
OTC
$1.7,
OTC $1.7,
11.4%
11.4%
PX
$1.7,
PX $1.7,
10.7%
10.7%
Non-prescribed
Non-prescribed Drugs
Drugs include
include
Over
the
Counter
Over the Counter Drugs
Drugs (OTC)
(OTC) and
and Personal
Personal Health
Health Supplies
Supplies (PX)
(PX)
Source:
Canadian
Institute
for
Health
Information
Source: Canadian Institute for Health Information
In 1976, the private sector accounted for over 75% of expenditure for prescribed drugs;
by 1992, it had decreased to 52.3%. The share of prescribed drugs financed from private
sources has increased steadily from 1992 to 1998 reaching 57.6%. In 1999, the share
fell to 55.6%, or $5.7 billion; in 2000 the share fell to 54.8%, or $6.4 billion. Forecasts
indicate that in 2001 and 2002 prescribed drugs expenditure in the private sector will be
$7.3 billion and $8.0 billion, respectively. In 2001 the private share of prescribed drugs is
expected to have fallen to 54.6%. In 2002 it is expected to have increased slightly to
55.0% of total spending, reflecting slightly lower relative growth in public sector drug
programs in that year (Figure 17).
Figure 17 - Prescribed Drug Expenditure, Public Sector vs.
Private Sector, Canada, 1975 to 2002
($' billions)
8.0
7.0
Public Sector
Private Sector
Forecast
6.0
5.0
4.0
3.0
2.0
1.0
0.0
1975
78
81
84
87
90
Year
Source: Canadian Institute for Health Information
20
93
96
99
2002
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Physicians
Physicians’ services constituted the third largest category of total health expenditure in
2000 at $13.0 billion, representing 13.3% of total health expenditure. Expenditure for
physicians’ services grew at above average rates through the mid-1980s, and peaked at
15.7% of total expenditure in 1987. Expenditure grew at below average rates during the
1990s, leading to a decline in the share of total expenditure. Physician expenditure is
forecast to have reached $14.0 billion in 2001, a 7.8% increase over the previous year, but
slightly lower growth than in other major categories. In 2002, this category is forecast to
have grown by 7.1% to reach $15.0 billion and reflecting 13.4% of total expenditure.
Just under 99% of total physicians’ services were financed from public sector sources in
2000. Public sector expenditure on physicians has remained above 98% of total physician
expenditure since 1975. The private share of physician expenditure was highest in the
decade from 1976 to 1986, when a number of provinces permitted supplementary charges
to patients (sometimes referred to as ‘extra billing’ or ‘balance billing’). The private share
reached a low of 0.9% from 1991 to 1993; by 2000 the private share of physician services
had reached its highest level since 1986, at 1.4%.
Physicians’ services were the second largest category of public sector health expenditure in
2000 at 18.6%, the same share as in 1982. Physician expenditure has maintained a share
of public sector expenditures ranging from 18.6% to 20.7%.
Households account for almost all private spending for physicians’ services. Insurance of
supplementary charges to patients for medically necessary services was discouraged prior
to the Canada Health Act, and such charges are not permitted under the Act. Physician
charges for uninsured services and administrative fees have not been insured as explicit
benefits of most insurance plans, but they may be insured under broad coverage terms that
include care not covered by public plans.
# Other Professionals
The broad category of other professionals includes primarily care provided by dentists and
denturists, optometrists and opticians, chiropractors, physiotherapists and, private duty
nurses. The category of other professionals accounted for $11.6 billion or 11.9% of total
expenditures in 2000 and has maintained the highest percentage of private spending of all
the major categories. The private share declined until 1981 reaching a low of 81.7%, and
gradually increased to over 89% in 2000. The private sector growth rates of this category
have been more consistent than in other categories, averaging 11.5% through the 1980s
and 6.6% from 1990 to 1997. Public sector growth was considerably higher than the
private sector from 1975 to the early 1980s, a period when the private sector share
declined by over five percentage points. Over 60% of expenditure for other professionals
is for dental care.
In 2002, total spending on other professionals is expected to have increased to
$13.0 billion, with a rate of growth of 4.6%.
21
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 18 - Other Professionals Expenditure by Source of Finance
and Type, Canada, 2000
($' billions)
Dentists
$0.4; 3.7%
Vision Care
$0.2; 2.0%
Private Sector
$10.4; 89.3%
Dentists
$6.8; 58.4%
Public Sector
$1.2; 10.7%
Other $0.6;
5.1%
Vision Care
$2.3; 20.2%
Other
$1.2; 10.6%
Source: Canadian Institute for Health Information
Dental care and vision care are the major discrete categories of expenditure in both the
public and private sector for other professional services (Figure 18). In the private sector,
insurance firms accounted for 56.0% of the amount spent for dental care in 2000. In the
same year households accounted for 80% of spending on vision care in the private sector.
Households also accounted for the majority of amounts spent for professionals providing
services other than dental or vision care e.g. physiotherapists, chiropractors, podiatrists,
massage therapists and private duty nurses. Estimates are not reported separately for these
professions by private sector data sources.
# Other Institutions
In 2000 the category of other institutions, which includes nursing homes and residential
care facilities, accounted for 9.4% of total expenditures, or $9.1 billion. Other institutions'
share of total health expenditure is forecast to have been 9.3% of total expenditure in 2001
and 2002.
Public expenditure is the main source of finance for other institutions. In many provinces
public responsibility is split between provincial and/or regional authorities; funding is often
provided both by health and social services departments. The public sector share has varied
over the last twenty years, fluctuating between 70% and 75% between 1975 and 1993,
reaching the highest level in the early 1980s. In 1994, the public sector share fell below 70%
for the first time in the series. In 2000 the public share of other institutions was 72.5%.
22
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Other Health Spending
Other health spending in past health expenditure reports was a broad category that included
several heterogeneous sub-categories including public health and administration. The subcategories with the greatest impact on the current category of other health spending are
prepayment administration (the administrative expenses of providing health insurance) and
health research6. The remaining categories include medical transportation, hearing aids and
appliances, occupational health and voluntary health associations and explicitly identified
home care.7 In 2000, other expenditures accounted for $8.1 billion or 8.3% of total health
expenditure.
Public sector sources accounted for 68.8% of other expenditures in 2000, most of which
was home care and ambulance services.
The broad category of other expenditures has grown faster than total health expenditure
every year since 1982, except in 1987, 1996 and 1998. In 2000, it is estimated to have
grown at 5.1%. In 2001 and 2002 it is expected that other health spending will have
grown by 6.1% and 4.9%, respectively, reaching $9.0 billion by 2002.
# Public Health and Administration
Public health and administration includes prevention and promotion activities and
infrastructure costs to operate health departments. Public health and administration
expenditure is reported in the public sector only.
In 1975, public health and administration accounted for 4.2% of total expenditure and
5.5% of public sector expenditure. Growth in this category has generally been higher than
in other categories throughout the series. During the period when governments practiced
policies of retrenchment in health care spending, particularly from 1992 to 1996, growth in
public health and administration was at least double the growth in total health expenditure.
This relative difference resulted in this category’s share of total expenditure increasing to
6.0% in 2000, or $5.8 billion. The share is expected to have increased to 6.1% in 2001,
but is expected to fall slightly in 2002 to 5.9%.
6
7
Research funded by pharmaceutical companies is funded from drug sales and included in the drugs category.
Certain services that are identified by data sources as home care are included under the broad category of "other—other
Health Spending". Private nursing care in the home, however, would be included in the "other—other professionals"
category. Home care programs provided by hospitals are included in the hospitals category. Support services such as
domestic maintenance and delivery of meals are considered to be social services within the current definition of home care
and are removed where identified.
23
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
P R O V I N C I A L A N D T E R R I T O R I A L
G O V E R N M E N T H E A L T H E X P E N D I T U R E
A G E A N D S E X 8
B Y
The population of Canada is aging rapidly by historical standards. The largest concentration
of population is in the middle age groups and moving upward. 9 The ‘baby-boomers’, who
are defined as those between 36 and 55 in 2001, represented approximately 32% of the
population in 2000. Population projections indicate that the cohort of persons between
35 and 55 will peak at 31.6% of the population in 2001 and then gradually decline over the
next twenty-five years to approximately 27% in 2026.9 The baby-boom cohort will affect
the size of the elderly population, which was estimated at 12.5% in 2000, and is projected
to grow to just over 21% by 2026 (using the traditional threshold of 65 years to define
elderly persons). Future health care costs for an aging population has been a topical issue
for a number of years.
The conventional wisdom holds that future demands for health care by an aging population
will strain governments’ ability to fund services covered under the Canada Health Act.
Canadian studies suggest that the effects of population growth and aging will be
manageable, however, within the context of a growing economy. Recent research into the
effects of population aging on all government expenditures concluded that government
expenditures, in total, can be expected to increase by approximately the same percentage
as population growth and by less than the growth in GDP.10
This section briefly looks at provincial and territorial government expenditures by age and sex.
CIHI has collected actual utilization data from national and provincial/territorial administrative
databases for major categories of service delivered by provincial and territorial governments,
from 1996 to 2000. A brief discussion is provided focusing on the age and sex distributions
in 2000 (for 19 age groupings), of the hospital and physician categories. In addition, the
analysis also examines provincial government health expenditure by age and sex and
standardizes expenditures for differences in provincial populations.
The complete set of estimates for five major categories including hospitals, physicians,
drugs, other institutions and other professionals, by eight age groupings from 1996 to 2000
are presented in the Series E Data Tables of this report.
8
9
10
A detailed explanation of methods and sources used to distribute provincial government health expenditure by age and sex
is available in the Methodology Notes section of this report.
Statistics Canada Population Projections. Medium growth estimate. CANSIM II table 052-0001.
Denton, F, & B. Spencer. Population Aging and Its Economic Costs: A Survey of the Issues and Evidence. Research
Institute for Quantitative Studies in Economics and Population, McMaster University, Hamilton, Ont., 2000.
24
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Hospital and Physician Expenditure
All residents are insured for hospital and physician plans under provisions of the Canada
Health Act. Provincial and territorial governments account for 90% of total expenditure for
hospitals and 97% for physicians services. These two categories accounted for
approximately two-thirds of provincial and territorial health expenditure in 2000.
Hospital expenditure for children under one year of age was approximately $1.48 billion in
2000, more than total expenditure for all children and teenagers from ages 1 to 19
($1.4 billion) (Figure 19). Hospital expenditure begins to increase steeply for females in the
15–19 age group, and continues to increase until it peaks in the 30–34 age group.
Expenditure declines during the late 30s and early 40s, and then remains stable until the
60s. Expenditure for males increases slightly in the last five years of the teens, and then
stays relatively stable until the 30s. Male expenditure is greater than female expenditure in
the 50–54 age group, and male expenditure exceeds female expenditure in each five-year
age group until age 75. Expenditure for males declines sharply after age 79, with
expenditure for females higher than expenditure for males in each age group.
Persons 65 and over accounted for over 48% of provincial government hospital expenditure
in Canada during 2000. Within this age group most was spent by 70 to 84 years old (31%
of total). Children under one year old accounted for 5%.
Hospital expenditure per capita exhibits a more striking age pattern than total expenditure.
Expenditure per capita exceeds $4,000 for both male and female infants under one year of
age, a level not reached again until the 80–84 age group (Figure 20). Expenditure per capita
drops to the range of $100 to $200 during the childhood and early teenage years. The
temporary increase in the female expenditure curve during the 20s and 30s is also
noticeable in per capita expenditure, peaking in the age groups from 25 to 35.
Expenditure per capita for both sexes remains under $1,000 until the 55–59 age group,
when it begins to increase rapidly. Hospital expenditure per capita is higher for males
than for females throughout the senior age groups. Higher total expenditure for females
after age 75 results from higher female populations over 75, which in turn is due to
greater longevity.
25
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 19 - Provincial/Territorial Government Hospital Expenditure,
by Age and Sex, Canada, 2000
($'000,000)
1,600
1,200
Male
Female
800
400
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
0
Age Group
Source: Canadian Institute for Health Information
Figure 20 - Provincial/Territorial Government Hospital Expenditure
Per Capita, by Age and Sex, Canada, 2000
$7,000
$6,000
$5,000
Male
$4,000
Female
$3,000
$2,000
$1,000
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
$0
Age Group
Sources: Canadian Institute for Health Information, Statistics Canada
Physicians’ services expenditure for females is slightly less than for males until age 14, and
consistently higher thereafter (Figure 21). Expenditure for females is highest between the
ages of 25 to 54, with those thirty years accounting for 45% of total expenditure for
females. Expenditure for males for the same thirty years, ages 25 to 54, accounts for 36%
of total expenditure for males.
26
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Expenditure per capita for physicians’ services follows a different age group distribution
than that observed for hospital services (Figure 22). Children under one exhibit relatively
high expenditure per capita, but the magnitude of differences between expenditure per
capita for infants and other children is much less in the case of physicians services than it is
in the case of hospitals (expenditure per capita for physicians services is approximately 3.3
times as great for infants as it is for the 5–9 age group, while it is over 36 times as great
for hospital services).
Figure 21 - Provincial/Territorial Government Physician
Expenditure, by Age and Sex, Canada, 2000
($'000,000)
600
500
Male
400
Female
300
200
100
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
Age Group
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
0
Source: Canadian Institute for Health Information
Expenditure per capita for females has a bimodal distribution, peaking at ages 25 to 34 and
again at ages 80–84, then falling off in the oldest age group. Expenditure per capita for
males has a fairly narrow range of $152 to $177 between the ages of 5 and 30, and then
increases steadily through the middle and elderly age groups, peaking at over $1,100 for
seniors over 74, then falling off in the oldest age group. Expenditure per capita for males is
consistently below the level for females in the same age group from age 15 to 64 and
consistently higher thereafter. As in the case of hospital services, a larger population of
women aged 70 and older is the main factor contributing to higher total expenditure for
physicians’ services by female seniors compared to males.
27
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 22 - Provincial/Territorial Government Physician
Expenditure Per Capita, by Age and Sex, Canada, 2000
$1,200
$1,000
$800
Male
$600
Female
$400
$200
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
$0
Age Group
Sources: Canadian Institute for Health Information, Statistics Canada
# Total Provincial/Territorial Government Expenditure11
The distribution of provincial/territorial government health expenditure by age and sex, in
millions of dollars and per capita dollars is shown in Figures 23 and 24. The influence of
hospital and physician expenditure is obvious in the shape of the curves.
Seniors, ages 65 and older, consumed more than 43% of all provincial government health
spending in 2000, while only comprising 12.5% of the population. Females accounted for
an estimated 56% of all provincial government spending in 2000, with female seniors
consuming the most at 25%. Senior males accounted for approximately 18% of total
expenditure. Infants accounted for less than 3% of total provincial government expenditure.
As in the case for hospital and physician services, there is high spending per capita for
infant care, with costs estimated to be greater than $5,000 per person for both genders.
From youths age 1, to adults age 54, spending per person slowly increases but does not
exceed $1,800 per person. There is a pronounced increase in per capita spending in the
senior age groups. Spending per capita for females exceeds that of males from ages
15 to 54 and again at ages greater than 84.
11
Missing data was estimated for this analysis. Refer to Age/Sex Distribution Methods in the Methodological Notes section of
this report for more details.
28
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 23 - Total Provincial/Territorial Government Health
Expenditure, by Age and Sex, Canada, 2000
($'000,000)
4,500
Males
Females
3,000
1,500
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
Age Group
Source: Canadian Institute for Health Information
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
0
Figure 24 - Total Provincial/Territorial Government Health
Expenditure Per Capita, by Age and Sex, Canada, 2000
$16,000
$12,000
Males
Females
$8,000
$4,000
Age Group
Sources: Canadian Institute for Health Information, Statistics Canada
29
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
1-4
<1
$0
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
P R O V I N C I A L A N D T E R R I T O R I A L
G O V E R N M E N T H E A L T H E X P E N D I T U R E
S T A N D A R D I Z E D F O R A G E A N D S E X
Provincial and territorial health expenditures per capita are quite similar because of universal
coverage for medically necessary hospital and physicians services under the Canada Health
Act. The 13 jurisdictions have different population age and sex profiles, however, which
could lead to systematic differences in total expenditure, even if per capita expenditure
were virtually the same for each age and sex group. Standardizing expenditure to a common
population distribution provides a means to measure differences that result from utilization
and prices.
Total provincial expenditure per capita, standardized for age and sex for 1998 to 2000, is
compared in Table 6. Distributions that were unavailable for specific categories of
expenditure were estimated for these comparisons. The data show both actual and
standardized expenditures. Standardized expenditures were calculated by multiplying the
male and female population of Canada in each of 19 age groups by the expenditure per
capita for each age group in each province and territory, and dividing the product so
obtained by the population of Canada.
Percentage differences between actual and standardized expenditure tend to be most
pronounced in Saskatchewan, Alberta and the territories. Newfoundland, Alberta and
the territories have lower than average percentages of their populations over 65, which
accounts for their increases in per capita expenditure when standardized to the national
population. Quebec and Ontario show little difference between actual and standardized
expenditure, due to their large shares of the total population. Other provinces show
lower expenditure per capita when data are standardized, with the declines ranging
from approximately two to six percent. Saskatchewan standardized expenditure per
capita is over six percent less than actual expenditure per capita for all three years
presented in this analysis.
For all three years, the territories have the highest standardized expenditure per capita. In
2000, Newfoundland, Alberta and Manitoba have the highest standardized expenditure
among the provinces. Alberta per capita spending increases from fourth highest actual
spending to second highest behind Newfoundland in age-sex standardized comparisons,
above the national average (Figure 25).
30
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 6—Total Provincial/Territorial Government Health Expenditure Per Capita Standardized
for Age and Sex, by Province/Territory and Canada, 1998 to 2000
1998
1999
2000
Actual
($)
Standardized
($)
Percent
Change
Actual
($)
Standardized
($)
Percent
Change
Actual
($)
Standardized
($)
Percent
Change
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
1,925
1,674
1,769
1,685
1,765
1,767
1,848
1,811
1,680
1,941
2,349
4,048
---
2,000
1,609
1,696
1,639
1,769
1,766
1,748
1,693
1,832
1,904
3,284
5,822
---
3.9%
-3.9%
-4.1%
-2.7%
0.2%
-0.1%
-5.4%
-6.5%
9.1%
-1.9%
39.8%
43.8%
---
2,195
1,747
1,858
1,812
1,798
1,872
2,096
1,946
1,904
2,074
2,505
4,317
3,911
2,264
1,673
1,780
1,764
1,798
1,874
1,998
1,823
2,071
2,030
3,473
6,114
5,541
3.1%
-4.2%
-4.2%
-2.7%
0.0%
0.1%
-4.7%
-6.3%
8.8%
-2.1%
38.6%
41.6%
41.7%
2,322
1,868
1,897
1,945
1,914
2,061
2,293
2,048
2,063
2,246
2,689
3,872
4,762
2,379
1,793
1,812
1,890
1,906
2,068
2,196
1,915
2,242
2,191
3,714
5,615
7,239
2.4%
-4.1%
-4.5%
-2.8%
-0.4%
0.3%
-4.2%
-6.5%
8.7%
-2.5%
38.1%
45.0%
52.0%
Canada
1,792
1,792
1,904
1,904
2,060
2,060
---
---
Sources: Canadian Institute for Health Information, Statistics Canada
Figure 25- Total Provincial/Territorial Government Health
Expenditure Per Capita, Age-Sex Standardized versus Actual, by
Province/Territory and Canada, 2000
$3,000
$1,500
$4,762
$7,239
$2,689
$3,714
$2,000
$3,872
$5,615
$2,500
$1,000
Actual
$500
Standardized
Canada Average
Sources: Canadian Institute for Health Information, Statistics Canada
31
Nu
n.
.
N.
W
.T
Y.
T.
.
B.
C
ta
.
Al
Sa
sk
.
an
.
M
O
nt
.
Q
ue
.
.
N.
B
.
N.
S
I.
P.
E.
Nf
ld
.
$0
---
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
H E A L T H E X P E N D I T U R E
A N D T E R R I T O R I E S
I N
T H E
P R O V I N C E S
Health expenditure per capita varies among provinces because of different age
distributions.12 Population density and geography also affect health expenditure, particularly
in the case of the territories. Other factors that affect health expenditure include population
health needs and the manner in which health care is delivered (including the balance
between institutional and ambulatory care). The manner in which health care is financed is
also an important consideration, including the degree of public coverage and private
insurance for services not included in the Canada Health Act and the level of remuneration
of health personnel.
Health expenditure per capita is highest in the Territories, largely because of their large
geographical areas and low population densities (Table 7). In 2000, expenditure per capita
is quite evenly distributed among the provinces, with Manitoba, Ontario and British
Columbia ranking highest with expenditures of between $3,260 and $3,500 per person.
Newfoundland, Alberta and Saskatchewan occupy fourth to sixth positions with
expenditures within a $107 range, between $3,056 and $3,163 per capita.
Health expenditure as a percent of GDP shows greater variation than expenditure per capita,
ranging from a low of 6.6% in Alberta to highs of 19.3% and 12.2% in Nunavut and
Newfoundland, respectively.
In 2000, the public sector was responsible for 70.8% of Canadian health expenditure.
The public sector share, with a median (mid-point) of 73.7%, varied considerably among
the provinces and territories. It exceeded 84% in the Territories, and was the lowest in
Ontario (67.3%).
Public sector expenditure per capita averaged $2,240 in 2000. After the territories,
Manitoba, Newfoundland, and British Columbia had the highest public sector expenditure;
Prince Edward Island, Quebec and Nova Scotia had the lowest.
Private sector expenditure averaged $924 per capita. Ontario led the thirteen jurisdictions,
followed by Alberta and Manitoba.
The 1990s witnessed a leveling of health expenditures, with declines or low growth in
expenditure per capita between 1992 and 1996. Expenditure per capita began to show
noticeable growth in most provinces beginning in 1998 or 1999 with double-digit growth
in some jurisdictions. Variations of this trend are expected to have continued in 2000 and
2002, however, growth is expected to slow in 2002, between 3.5% and 8.3%.
12
Provincial comparisons in this discussion are based on figures that are not adjusted for variations in age and sex. For age
sex standardized comparisons see the discussion in the previous section.
32
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 7—Health Expenditure Summary, by Province/Territory and Canada, 2000
Percent
Expenditure
Distribution
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
($' 000,000)
1,683.0
396.3
2,800.4
2,224.3
21,185.3
38,746.5
4,012.3
3,123.4
9,521.5
13,235.9
115.3
214.4
161.6
97,420.0
(%)
1.7
0.4
2.9
2.3
21.7
39.8
4.1
3.2
9.8
13.6
0.1
0.2
0.2
100.0
Total
Health
Total Expenditure per
Exp. as
Capita
Percent
of GDP
($)
3,129
2,865
2,972
2,944
2,870
3,312
3,500
3,056
3,163
3,260
3,768
5,249
5,876
3,164
Change
since '99
(%)
7.6
5.1
5.2
7.6
6.1
8.3
9.2
6.0
8.3
7.3
8.4
-7.6
20.1
7.5
(%)
12.2
11.7
11.6
11.1
9.5
8.9
12.0
9.3
6.6
10.2
10.0
8.0
19.3
9.1
Public
Sector
Exp. per
Capita
Private
Sector
Exp. per
Capita
($)
2,456
2,009
2,094
2,098
2,080
2,230
2,622
2,328
2,255
2,403
3,181
4,770
5,556
2,240
($)
673
856
877
846
790
1,082
878
729
908
857
587
479
320
924
Public
Sector as
Percent of
Total
(%)
78.5
70.1
70.5
71.3
72.5
67.3
74.9
76.2
71.3
73.7
84.4
90.9
94.5
70.8
Source: Canadian Institute for Health Information
Public sector expenditure per capita declined in all twelve jurisdictions at some time during
the 1990s, although the timing and duration of expenditure reductions varied. Quebec,
Saskatchewan and Alberta experienced the sharpest declines, while the decline in Ontario
was the most protracted with declines in each of the four years from 1993 to 1996
(Figure 26). All jurisdictions recovered from their declines during the latter half of the decade.
British Columbia experienced the most stability in public sector expenditure per capita during
the five years from 1993 to 1997, and stayed at or near the top of provincial rankings during
that time. Current forecasts indicate that Manitoba, British Columbia and Newfoundland will
have the highest levels of public expenditure per capita among the provinces in 2002, while
Nova Scotia, Quebec and Ontario are expected to have the lowest.
33
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 26—Public and Private Sector Health Expenditure Per Capita, 1988 to 2002,
by Province and Territory—Current Dollars
Newfoundland
Prince Edward Island
$3,000
$2,500
$2,000
$3,000
Public
Private
Forecast
Public
Private
Forecast
$2,500
$2,000
$1,500
$1,500
$1,000
$1,000
$500
$500
$0
$0
1988 90 92 94 96 98 00 02
Year
1988 90 92 94 96 98 00 02
Year
Nova Scotia
New Brunswick
$3,000
$2,500
$2,000
$3,000
Public
Private
Forecast
$2,000
$1,500
$1,500
$1,000
$1,000
$500
$500
$0
$0
1988 90 92 94 96 98 00 02
1988 90 92 94 96 98 00 02
Quebec
$3,000
$3,000
$2,500
$2,000
Public
Private
Forecast
$2,500
$2,500
Public
Private
Forecast
$2,000
$1,500
$1,500
$1,000
$1,000
$500
$500
$0
$0
1988 90 92 94 96 98 00 02
Ontario
Public
Private
Forecast
1988 90 92 94 96 98 00 02
Sources: Canadian Institute for Health Information, Statistics Canada
34
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 26 (cont’d)—Public and Private Sector Health Expenditure Per Capita,
1988 to 2002, by Province and Territory—Current Dollars
Manitoba
$3,000
$2,500
Saskatchewan
$3,000
Public
Private
Forecast
$2,500
$2,000
$2,000
$1,500
$1,500
$1,000
$1,000
$500
$500
$0
$0
198890 92 94 96 98 00 02
1988 90 92 94 96 98 00 02
Alberta
$3,000
$2,500
Public
Private
Forecast
British Columbia
$3,000
Public
Private
Forecast
$2,500
$2,000
$2,000
$1,500
$1,500
$1,000
$1,000
$500
$500
$0
$0
198890 92 94 96 98 00 02
Public
Private
Forecast
198890 92 94 96 98 00 02
Sources: Canadian Institute for Health Information, Statistics Canada
35
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 26 (cont’d)—Public and Private Sector Health Expenditure Per Capita,
1988 to 2002, by Province and Territory—Current Dollars
Yukon Territory
$6,000
$5,000
Northwest Territories
$6,000
Public
Private
Forecast
$5,000
$4,000
$4,000
$3,000
$3,000
$2,000
$2,000
$1,000
$1,000
$0
$0
198890 92 94 96 98 00 02
Public
Private
Forecast
198890 92 94 96 98 00 02
Nunavut Territories
$6,000
$5,000
Public
Private
Forecast
$4,000
$3,000
$2,000
$1,000
$0
198890 92 94 96 98 00 02
Sources: Canadian Institute for Health Information, Statistics Canada
The provincial trends in Figure 26, which are not adjusted for inflation, show modest private
sector growth in most provinces. Ontario private sector expenditure showed the steepest
growth curve in the 1990s. By 2002, Ontario is expected to have the highest private sector
expenditure per capita at $1,226. Newfoundland, Nova Scotia, New Brunswick, Quebec,
Saskatchewan and the territories experienced reductions in private sector expenditure
during brief periods of the 1990s. In Quebec the decline was only one year in duration but
the Northwest Territories showed a slight downward trend from 1992 to 1997.
36
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Provinces and Territories
Provincial rates of increase are compared in Figures 27, 28 and 29. The comparisons focus
on growth of health expenditure per capita at constant prices. This is to standardize for
both population growth and inflation, which have varied by province during the last two
decades.13 The graphs compare average annual growth rates in the public and private
sectors during the fifteen years from 1975 to 1990 (Figure 27), the seven years from 1990
to 1996 (Figure 28) and the five years from 1996 to 2000 (Figure 29). The choice of time
periods has some effect on annual average growth rates. In particular, both sectors have
experienced quite different rates of growth during specific periods of the 1990s, although
the timing of trends has been different, both between sectors and among provinces, as
discussed above. Because the early 1990s have witnessed policies of health system reform
and public expenditure restraint in virtually all jurisdictions, this decade is viewed separately
in comparisons of expenditure trends. This expenditure restraint relaxed over the period
between 1996 and 2000, which saw significant public reinvestment in the health sector,
hence this period is also viewed separately.
2.5%
2.9%
1.3%
2.6%
2.4%
2.6%
2.5%
3.3%
0.4%
2.8%
2.7%
2.6%
3.0%
3.2%
4.2%
4.4%
1.8%
1.4%
2.5%
1.9%
1.1%
3.2%
3.3%
3.4%
5.0%
4.9%
Figure 27 - Real Average Annual Rates of Growth of Public and
Private Expenditure Per Capita, by Province/Territory and Canada,
1975 to 1990
Sources: Canadian Institute for Health Information, Statistics Canada
ad
a
.T
C
-1.6% an
N.
W
Y.
T.
.
B.
C
lta
.
A
.
Sa
sk
nt
.
an
.
M
Private
-5.7%
Public
O
Q
ue
.
N.
B.
N.
S.
.
Nf
ld
-2.5%
P.
E.
I.
0.0%
1975 to 1990
Public and private sector annual growth rates for Canada, and in most provinces, were
close between 1975 and 1990. Growth rates between the two sectors were nearly
identical in Nova Scotia, Manitoba and Alberta. Relatively large discrepancies between the
two sectors were evident in Newfoundland, Quebec, Saskatchewan and the territories.
13
The indexes used to measure inflation are the implicit price index for government current expenditure in the public sector
and the Consumer Price Index health component in the private sector. Both indexes track prices separately in each province
and territory (see Calculation Methods in the Methodological Notes section of this report).
37
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Public sector growth rates tended to be higher than the Canadian average in three of the
Atlantic Provinces, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia and the
Northwest Territories, and lower in Prince Edward Island, Quebec and the Yukon. The
Northwest Territories experienced the highest rates of public sector expenditure growth
while the Yukon experienced the lowest. The four provinces from Nova Scotia to Ontario
experienced the highest private sector growth rates; Saskatchewan had the lowest; the
territories experienced decreases in private sector expenditure.
1990 to 1996
The trends in expenditure at constant prices between 1990 and 1996 tend to be closer to
trends at market prices than they were in the earlier period, due to relatively low levels of
inflation after 1992.
Public sector expenditure per capita at constant prices declined by an average of 0.6%
annually from 1990 and 1996. Different trends were followed from east to west, with
Newfoundland, Prince Edward Island and New Brunswick showing small increases, and all
other jurisdictions, except the Yukon, experiencing decreases. Among the provinces,
Alberta experienced the largest decline, followed by Saskatchewan. Even among provinces
experiencing growth during this period, public sector expenditure growth was substantially
less than its average during the previous 15 years.
2.2%
.
-1.3% T
Ca
-5.3%
na
d
-0.6% a
5.7%
18.3%
-0.2%
Y.
T.
lta
.
-3.0%
-1.5%
A
k.
Sa
s
an
.
-0.2%
M
O
nt
.
-0.3%
Q
ue
.
-0.3%
0.5%
B.
C
.
-0.4%
2.5%
0.3%
0.4%
N.
B.
N.
S
-0.9% .
-2.5%
P.
E.
I.
Nf
ld
.
0.0%
Private
N.
W
3.5%
Public
1.7%
2.4%
1.7%
2.5%
1.4%
3.3%
5.0%
3.3%
4.3%
Figure 28 - Real Average Annual Rates of Growth of Public and
Private Expenditure Per Capita, by Province/Territory and Canada,
1990 to 1996
Sources: Canadian Institute for Health Information, Statistics Canada
Real private sector expenditure per capita in Canada grew at similar rates during the 1990s
as during the previous 15 years (2.2% and 2.9% respectively). Figure 28 shows a wavelike pattern among provinces and territories, cresting in Prince Edward Island, Manitoba and
Yukon. British Columbia and the Northwest Territories experienced declines, while the
private sector grew in New Brunswick and Alberta by less than 1.0%.
38
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
1996 to 2002
Public reinvestment in health care near the end of the 1990s contributed to significant
increases in growth rates of public health expenditure across Canada. Public sector health
expenditure per capita at constant prices grew by an average of 4.4% annually between
1996 and 2000. The highest growth rates are found in Newfoundland, Manitoba and
Alberta. The lowest growth rates are found in Prince Edward Island, the Yukon Territory and
New Brunswick.
4.4%
3.7%
3.2%
2.8%
3.6%
3.1%
0.1%
2.5%
Private
2.6%
6.6%
4.2%
3.9%
4.3%
4.4%
3.3%
2.8%
1.4%
0.5%
3.4%
2.8%
5.8%
5.5%
4.9%
5.0%
Public
6.0%
7.1%
Figure 29 - Real Average Annual Rates of Growth of Public and
Private Expenditure Per Capita, by Province/Territory and Canada,
1996 to 2000
5.8%
7.2%
All provinces experienced an increase in real private sector expenditure per capita from
1996 to 2000. On average, real private per capita health expenditures grew by 3.7%.
Newfoundland, New Brunswick and Alberta experienced growth rates higher than 5%. The
Yukon Territory and Prince Edward Island saw the smallest annual increase in private sector
health expenditure, with growth rates of less than 1%.
.T
ad
a
Ca
n
N.
W
Y.
T.
.
B.
C
lta
.
A
Sa
sk
.
an
.
M
nt
.
O
Q
ue
.
N.
B.
N.
S.
P.
E.
I.
Nf
ld
.
0.0%
Sources: Canadian Institute for Health Information, Statistics Canada
In 2001 and 2002, real public sector expenditure per capita health expenditure is forecast
to grow by 6.0% and 1.8%, respectively. All provinces are expected to have growth rates
above 6.0% in 2001 except Nova Scotia and Ontario, which are expected to have rates of
3.2%. Prince Edward Island and Alberta are forecast to have growth rates above 10.0%. In
2002, Newfoundland, Nova Scotia, Quebec and Saskatchewan are expected to have
growth of less than one percent. Quebec is forecast to experience a decline in spending of
three-tenths of one percent. Growth in real per capita public sector health expenditure in
Prince Edward Island is expected to be above 6.0% in 2002.
Private sector per capita health expenditure at constant prices is forecast to have been
4.5% and 3.5% in 2001 and 2002, respectively. Private sector expenditure are expected to
grow in all jurisdictions except Nunavut.
39
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
I N T E R N A T I O N A L
C O M P A R I S O N S
# Comparability of Health Expenditure Across Countries
For the last two annual updates of the health database maintained by the Organisation for
Economic Cooperation and Development (OECD), member-countries were asked to report
health expenditure according to concepts presented in the OECD manual A System of
Health Accounts (SHA), released in May 2000. Countries are at varying stages of reporting
total health expenditure according to the boundary of health care proposed in the SHA
manual. This means that data presented in OECD Health Data 2002 are at varying levels of
comparability. This section shows health expenditure information for the twelve countries
that most closely follow the health care boundary proposed in the OECD manual. The OECD
states that the data for those countries are believed to be fairly comparable, although some
deviations from SHA definitions may still exist among the sub-aggregate variables of total
health expenditure14. The twelve countries are Australia, Canada, Denmark, France,
Germany, Hungary, Japan, Korea, the Netherlands, Switzerland, the United Kingdom and
the United States.
# Comparability of Health Expenditure Over Time
In the last two years, countries adopted the SHA to report their data for the most recent
years. Many countries have yet to revise their series for earlier years. Breaks in series thus
appear in most of the twelve countries in the mid to late 1990s.
The data presented in OECD Health Data 2002 are based on the SHA starting in the
following years:
Australia: 1998
Canada: 1975
Denmark: 1971
France: 1990
Germany: 1991
Hungary: 1998
Japan: 1998
Korea: 1995
Netherlands: 1998
Switzerland: 1995
United Kingdom: 1997
United States: 1999
Due to the change in reporting systems, this section on international comparisons focuses
on data for 2000, the most recent year for which data are available for all twelve countries,
rather than on trends.
14
See Data Comprehensiveness and Boundaries of Health Care at the end of the International Comparisons section.
40
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# OECD Definition of Total Health Expenditure
Total expenditure on health is defined by the OECD as the sum of expenditure on activities
that—through application of medical, paramedical, and nursing knowledge and technology—
has the goals of:
• Promoting health and preventing disease;
• Curing illness and reducing premature mortality;
• Caring for persons affected by chronic illness who require nursing care;
• Caring for persons with health-related impairments, disability, and handicaps
who require nursing care;
• Assisting patients to die with dignity;
• Providing and administering public health;
• Providing and administering health programmes, health insurance and other
funding arrangements.
Activities such as food and hygiene control, health research and development, and training of
health workers are considered health-related, but are not included in total health expenditure.
# Health Expenditure and GDP
A higher level of public and private spending on health reduces the share of GDP that is left
to purchase other goods and services. While there is more than a threefold variation in
health expenditure per capita between some countries, the share of GDP spent on health
does not vary as widely. This reflects the fact that the level of health expenditure is driven
in part by the level of GDP.
Total Health Expenditure as a Percent of GDP—2000
Canada is among the five countries with the highest ratio of total health expenditure to
GDP.15 In 2000, the United States had the highest ratio of total health expenditure to GDP
at 13.0%, followed by Switzerland and Germany respectively at 10.7% and 10.6%.
Although health expenditure per capita in Canada was higher than in France, Canada’s
higher GDP per capita produced a lower health to GDP ratio at 9.1% compared with 9.5%
for France. Australia, Denmark, the Netherlands and Japan16 had similar ratios ranging
between 7.8% and 8.3%. The share of health expenditure in GDP was 7.3% in the United
Kingdom16 and 6.8% in Hungary. Korea had the lowest ratio at 5.9%. (Figure 30)
15
The OECD GDP figures are standardized for international comparability; consequently, the health expenditure to GDP ratios
reported by the OECD may differ from those reported by the national health accounts of member countries. Specific to
Canada, the GDP estimate published by Statistics Canada contains an amount for Financial Intermediation Services
Indirectly Measured (FISIM). Statistics Canada removes the FISIM from the GDP estimate provided to the OECD. In
addition, there is a time lag between both Statistics Canada's revision of the Canadian GDP and CIHI’s revision of national
health expenditure data, and their publication in OECD reports.
16
Notes provided to the OECD by Japan and the United Kingdom suggest that there may be a non-negligible underreporting of private sector expenditures in these two countries. See section on Data Comprehensiveness and Boundaries
of Health Care.
41
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 30 - Total Health Expenditure as a Percent of GDP,
Twelve Selected Countries, 2000
United States
13.0%
Switzerland
10.7%
Germany
10.6%
France
9.5%
CANADA
9.1%
Australia
8.3%
Denmark
8.3%
Netherlands
8.1%
Japan
7.8%
United Kingdom
7.3%
Hungary
6.8%
Korea
0.0%
5.9%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
Source: OECD Health Data 2002, 4th Edition
Total Health Expenditure as a Percent of GDP—Trends 1975 to 2000
The health to GDP ratio is provided in Table 8 for nine countries starting in 1975. Data for
France, Hungary and Korea are only available at a later date. There are some breaks in
series due to the adoption of the SHA for international reporting and caution should be
exercised in interpreting the data although the impact of the break is believed to be
lessened somewhat when the first and last year of a long time series are considered. All
countries with available data back to 1975 experienced an increase in their health to GDP
ratio over the 25 years, with the exception of Denmark that had a decrease of about half a
percentage point. Health expenditure as a percent of GDP in the United States was more
than five percentage points higher in 2000 than in 1975. Switzerland followed with an
increase of more than 4 percentage points in its health to GDP ratio. Japan and the United
Kingdom had similar increases as Canada, about 2 percentage points. In Australia and the
Netherlands, the proportion of GDP represented by health expenditure in 2000 was about
1 percentage point higher than in 1975. During the late 1970s, Canada’s total health to
GDP ratio was relatively constant, but it grew steadily during the 1980s with significant
increases during the recessions of the early 1980s and 1990s. The ratio began to decline
after it peaked at 10.0% in 1992. Denmark, Hungary, the Netherlands, and the United
States also had peaks around 1993 to 1995, followed by declines.
42
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Table 8—Total Health Expenditure as a Percent of GDP for Selected Countries,
1975 to 2000
(Caution—breaks in series: Bolded italicized figures are before the adoption of the SHA)
Year Australia Canada Denmark France Germany
Hungary Japan Korea Netherlands Switzerland
United United
Kingdom States
1975
1976
1977
1978
1979
7.2
7.2
7.4
7.3
7.0
7.1
7.1
7.0
7.0
6.9
8.9
8.8
8.6
8.7
8.8
8.8
8.7
8.6
8.7
8.5
5.6
5.6
5.7
5.9
6.0
7.2
7.0
7.1
7.2
7.4
7.2
7.4
7.4
7.4
7.5
5.5
5.5
5.3
5.3
5.3
7.8
8.0
8.2
8.1
8.2
1980
1981
1982
1983
1984
7.0
7.0
7.3
7.3
7.3
7.1
7.3
8.1
8.3
8.2
9.1
9.3
9.3
9.0
8.7
8.8
9.2
9.1
9.0
9.1
6.4
6.5
6.7
6.8
6.5
7.5
7.7
7.9
7.8
7.5
7.6
7.6
7.8
8.2
8.0
5.6
5.9
5.8
6.0
6.0
8.7
9.0
9.8
9.9
9.8
1985
1986
1987
1988
1989
7.4
7.7
7.4
7.3
7.4
8.2
8.5
8.4
8.3
8.5
8.7
8.3
8.6
8.8
8.6
9.3
9.1
9.2
9.4
8.8
6.6
6.6
6.6
6.3
6.1
4.3
4.1
4.0
4.2
4.8
7.3
7.5
7.6
7.7
8.0 (c)
8.0
8.2
8.5
8.5
8.6
5.9
5.9
6.0
5.9
5.9
10.0
10.2
10.4
10.8
11.2
1990
1991
1992
1993
1994
7.8
8.0
8.1
8.1
8.1
9.0
9.7
10.0
9.8
9.5
8.5
8.4
8.5
8.8
8.5
8.6(a)
8.9
9.1
9.5
9.4
9.9(b)
9.9
10.2
7.1
7.7
7.7
8.3
5.9
5.9
6.2
6.4
6.7
4.8
4.5
4.7
4.7
4.7
8.0
8.2
8.4
8.5
8.4
8.5
9.2
9.6
9.6
9.8
6.0
6.5
6.9
6.9
7.0
11.9
12.6
13.0
13.3
13.2
1995
1996
1997
1998
1999
8.2
8.3
8.4
8.5
8.4
9.1
8.9
8.9
9.1
9.2
8.2
8.3
8.2
8.4
8.5
9.6
9.6
9.4
9.3
9.4
10.6
10.9
10.7
10.6
10.7
7.5
7.2
7.0
6.9
6.8
7.0
7.0
7.2
7.1
7.4
4.7
4.9
5.0
5.1
5.6
8.4
8.3
8.2
8.1
8.2
10.0
10.4
10.4
10.6
10.7
7.0
7.0
6.8
6.8
7.1
13.3
13.2
13.0
12.9
13.0
2000
8.3
9.1
8.3
9.5
10.6
6.8
7.8
5.9
8.1
10.7
7.3
13.0
8.7
(a) Data before 1990, shown in OECD Health Data 2001, were deleted from OECD Health Data 2002.
(b) Data up to 1990 refer to the former Federal Republic; data from 1992 onwards correspond to Germany after reunification.
(c) Data before and after 1989 are not comparable. Starting in 1989 integrated service organisations and maternity centres
were excluded and institutions for home health and social services were included.
Source: OECD Health Data 2002, 4th Edition
Public Sector Health Expenditure as a Percent of GDP—2000
With regard to public sector spending on health as a percentage of GDP in 2000, Canada
falls within the top third of countries. Public sector health expenditure accounted for 8.0%
of Germany’s GDP, the highest proportion among the twelve countries. France, Denmark
and Canada had ratios ranging between 6.5% and 7.2%. Public sector spending on health
represented an almost identical proportion of GDP (about 6%) in five countries: Australia,
Switzerland, Japan, the United Kingdom and the United States. The ratios in the
Netherlands and Hungary were somewhat lower than for these five countries at 5.5% and
5.1% respectively. Spending on health by the public sector in Korea was only 2.6% of GDP
(Figure 31).
43
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 31 - Public Sector Health Expenditure as a Percent of GDP,
Twelve Selected Countries, 2000
Germany
8.0%
France
7.2%
Denmark
6.8%
CANADA
6.5%
Australia
6.0%
Switzerland
6.0%
Japan
5.9%
United Kingdom
5.9%
United States
5.8%
Netherlands
5.5%
Hungary
5.1%
Korea
0.0%
2.6%
2.0%
4.0%
6.0%
8.0%
Source: OECD Health Data 2002, 4th Edition
Private Sector Health Expenditure as a Percent of GDP—2000
Private sector health expenditure represented 7.2% of GDP in the United States in 2000, by
far the highest percentage among the twelve countries. Switzerland and Korea followed at
4.7% and 3.3% respectively. Canada is within a group of five countries with very similar
private sector health expenditure to GDP ratios ranging between 2.3% and 2.6%; other
countries in this group are Germany, the Netherlands, Australia and France. The countries
with the lowest ratios, ranging between 1.4% and 1.8%, comprise Japan16, Hungary,
Denmark, and the United Kingdom16 (Figure 32).
Figure 32 - Private Sector Health Expenditure as a Percent of GDP,
Twelve Selected Countries, 2000
United States
7.2%
Switzerland
4.7%
Korea
3.3%
Germany
2.6%
Netherlands
2.6%
CANADA
2.5%
Australia
2.3%
France
2.3%
Japan
Hungary
Denmark
United Kingdom
0.0%
1.8%
1.6%
1.5%
1.4%
2.0%
4.0%
Source: OECD Health Data 2002, 4th Edition
44
6.0%
8.0%
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
# Health Expenditure Per Capita17
Total Health Expenditure per Capita—2000
Canada, with a per capita spending of $2,535, is among the four countries with the highest
spending on health per capita. The United States had by far the highest health expenditure
per capita ($4,631) in 2000. Switzerland had the second highest per capita spending, but
almost a third lower at $3,222. Health expenditure per capita in Germany, Canada,
Denmark and France was rather similar, ranging between $2,349 and $2,748, but
considerably lower than in Switzerland. The Netherlands, Australia and Japan followed with
a range of expenditure per capita between $2,012 and $2,246. Per capita spending in the
United Kingdom was significantly lower than in these three countries at $1,763. Korea and
Hungary had the lowest health expenditure per capita at $893 and $841 respectively
(Figure 33).
Figure 33 - Total Health Expenditure Per Capita in US Dollars,
Twelve Selected Countries, 2000
$4,631
United States
Switzerland
$3,222
$2,748
Germany
$2,535
CANADA
Denmark
$2,420
$2,349
France
Netherlands
$2,246
Australia
$2,211
$2,012
Japan
$1,763
United Kingdom
Korea
$893
$841
Hungary
$0
$1,000
$2,000
$3,000
$4,000
$5,000
Source: OECD Health Data 2002, 4th Edition
17
Health expenditure per capita were converted to US dollars using purchasing power parities (PPPs) for GDP, which are
designed to eliminate differences in price levels between countries—i.e. PPPs equalize the purchasing power of different
currencies.
45
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Public Sector Health Expenditure per Capita—2000
Canada falls within the top third of countries for the level of health spending by the public
sector per capita. Health expenditure by the public sector per capita in 2000 was similar in
Germany, the United States and Denmark, ranging between $1,986 and $2,063. A second
group of countries that includes Canada, Switzerland and France had public sector health
expenditure per capita in a narrow range around $1,800. The per capita expenditure varied
between $1,500 and $1,600 in Australia, Japan and the Netherlands. Public spending per
capita was lower in the United Kingdom at $1,420. Hungary and Korea reported much
lower public sector health expenditure per capita than other countries (Figure 34).
Figure 34 - Public Sector Health Expenditure Per Capita in US
Dollars, Twelve Selected Countries, 2000
Germany
$2,063
United States
$2,051
$1,986
Denmark
$1,826
CANADA
Switzerland
$1,793
$1,785
France
$1,600
Australia
Japan
$1,542
$1,517
Netherlands
$1,429
United Kingdom
Hungary
$637
$396
Korea
$0
$500
$1,000
$1,500
$2,000
Source: OECD Health Data 2002, 4th Edition
Private Sector Health Expenditure per Capita—200016
Canada, with a private sector spending per capita of $709, is among the four countries
with the highest health expenditure per capita funded by the private sector. Private sector
spending per capita was considerably higher than in Canada only in the United States
($2,580) and Switzerland ($1,429). Private sector health expenditure per capita in the
Netherlands and Germany, amounting to $729 and $685 respectively, were close to
Canada’s level. The per capita expenditure was around $600 in Australia and France and
roughly $500 in Korea and Japan. The three countries with the lowest health expenditure
per capita funded by the private sector were Denmark ($434), the United Kingdom ($335)
and Hungary ($205) (Figure 35).
46
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 35 - Private Sector Health Expenditure Per Capita in US
Dollars, Twelve Selected Countries, 2000
$2,580
United States
Switzerland
$1,429
Netherlands
$729
CANADA
$709
Germany
$685
$611
Australia
$564
France
Korea
$497
$469
Japan
$434
Denmark
United Kingdom
$335
$205
Hungary
$0
$500
$1,000
$1,500
$2,000
$2,500
Source: OECD Health Data 2002, 4th Edition
#
Total Health Expenditure by Use of Funds—2000
Expenditure on medical services and expenditure on medical goods are two major
expenditure categories. Taken together, they represent expenditure on personal health care
and account for more than 85% of total health expenditure in each of the eleven countries
for which the breakdown of total health expenditure is available (the breakdown is not
available for the United Kingdom) (Figure 36).
Expenditure on medical services is composed of expenditure on inpatient care and
expenditure on other medical services18. Inpatient care is mainly delivered in hospitals but
also in nursing and residential care facilities. Expenditure on other medical services includes
all expenditures on day care, outpatient care (in hospitals, physicians’ and dentists’ offices,
outpatient care centres, etc.), ancillary services provided to outpatients such as laboratory
services and diagnostic imaging, and home care.
Expenditure on medical goods (dispensed to outpatients) comprises mostly expenditure on
pharmaceuticals and other medical non-durables, but also, to a lesser extent, expenditure on
therapeutic appliances and other medical durables such as eyeglasses, hearing aids, artificial
limbs, wheelchairs, etc.
18
The two components of medical services are not shown separately in Figure 36, as each component was not reported
consistently among countries. Some countries included, under inpatient care, expenditures that should have been included
under other medical services.
47
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Among the eleven countries for which the breakdown of total health expenditure is
available, expenditure on medical services accounted for about 70% or 75% of total
expenditure, with the exception of Denmark where the proportion was 82% and Hungary
where it was 53%.
Expenditure on medical goods accounted for the highest percentage of total health
expenditure in Hungary (35%), followed by France (24%) and Germany (19%). Expenditure
on medical goods ranged between 15% and 17% of total health expenditure within a
middle group of four countries: Japan, Canada, the Netherlands, and Korea. Another group
of four countries that include Denmark, Switzerland, Australia and the United States had
the lowest percentages, around 12% or 13%.
Figure 36 - Expenditure on Personal Health Care as a Percent of
Total Health Expenditure, Eleven Selected Countries, 2000
82%
Denmark
69%
France
77%
Switzerland
73%
Japan (b)
24%
Medical Serv.
13%
Medical Goods
17%
77%
Australia (a)
Hungary
12%
13%
53%
35%
75%
United States
13%
68%
Germany
19%
CANADA
71%
16%
Netherlands
72%
15%
71%
Korea (b)
0.0%
20.0%
16%
40.0%
60.0%
80.0%
100.0%
Source: OECD Health Data 2002, 4th Edition
(a)
(b)
Data for 1998.
Data for 1999.
# Public Share of Health Expenditure—2000
Public Share of Total Health Expenditure—2000
Expenditure by the public sector represented more than 80% of total health expenditure in
Denmark and the United Kingdom. However, private sector expenditures in the United
Kingdom are believed to be under-reported. Canada is within a group of six countries with a
public sector share ranging between 70% and 80% of total health expenditure. The share
funded by the public sector was a bit lower in the Netherlands, at 67.5%. The three
countries with the lowest public sector shares in descending order are Switzerland (55.6%),
Korea (44.4%) and the United States (44.3%) (Figure 37).
48
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Figure 37 - Public Share of Total Health Expenditure, Twelve
Selected Countries, 2000
Denmark
82.1%
United Kingdom
81.0%
Japan
76.7%
France
76.0%
Hungary
75.7%
Germany
75.1%
Australia
72.4%
CANADA
72.0%
Netherlands
67.5%
Switzerland
55.6%
Korea
44.4%
United States
44.3%
0.0%
20.0%
40.0%
60.0%
80.0%
Source: OECD Health Data 2002, 4th Edition
Public Share of Expenditure on Medical Services—2000
More than 80% of expenditures on medical services were financed by the public sector in
Denmark, Japan, Hungary and France (data are not available for the United Kingdom). The
public sector share ranged between 70% and 80% for the group of four countries that
includes Canada, along with Germany, the Netherlands and Australia. The public sector
share was about 50% in Switzerland, Korea and the United States (Figure 38).
Figure 38 - Public Share of Expenditure on Medical Services,
Eleven Selected Countries, 2000
89.1%
Denmark
Japan (b)
85.6%
Hungary
85.5%
83.0%
France
Germany
77.9%
CANADA
77.4%
75.8%
Netherlands
72.5%
Australia (a)
52.8%
Switzerland
49.4%
Korea (b)
47.6%
United States
0.0%
20.0%
40.0%
Source: OECD Health Data 2002, 4th Edition
(a) Data for 1998.
(b) Data for 1999.
49
60.0%
80.0%
100.0%
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Public Share of Expenditure on Medical Goods—2000
Germany had the highest share of expenditure on medical goods (dispensed to outpatients)
financed by the public sector (64.0%) among the eleven countries for which data were
available (data were missing for the United Kingdom). The public sector share was about
60% in five countries: Japan, the Netherlands, Hungary, Switzerland, and France.
Australia’s share was substantially lower at 49.7%. Canada and Denmark had similar public
sector shares, respectively 37.6% and 36.8%. The public sector funded the lowest shares
of expenditure on medical goods in the United States (19.3%) and Korea (4.8%)
(Figure 39).
Figure 39 - Public Share of Expenditure on Medical Goods,
Eleven Selected Countries, 2000
Germany
64.0%
61.2%
Japan (b)
Netherlands
60.7%
Hungary
59.8%
Switzerland
59.4%
France
59.1%
Australia (a)
49.7%
CANADA
37.6%
Denmark
36.8%
United States
Korea (b)
0.0%
19.3%
4.8%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Source: OECD Health Data 2002, 4th Edition
(a) Data for 1998.
(b) Data for 1999.
! Total Health Expenditure by Source of Finance—2000
Public Sector Sources of Finance—2000
Figure 40 shows the twelve countries in descending order according to the share of total
health expenditure financed by the public sector.
The public sector includes two sub-sectors: 1) General governments, including central,
state/regional and local government authorities, and 2) Social security funds, which are
social insurance schemes covering the entire community or large sections of the community
and that are imposed and controlled by government units.
Generally, the level of public sector financing appears to be unrelated to the choice of subsectors through which the countries provide funding. Expenditures by the public sector
represented more than 80% of total health expenditure in Denmark and the United
Kingdom. General governments financed all of the public sector spending in the two
50
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
countries. Canada falls within a group of six countries with a public sector share ranging
between 70% and about 80% of total health expenditure. In four out of six countries
(Japan, France, Hungary and Germany), social security funds were by far the most
important source of finance, in contrast to Canada where only 1.2% of health expenditures
were financed by social security funds and Australia where general governments were the
sole source of public sector funding. In Canada, social security funds include the health care
spending by workers’ compensation boards and the drug insurance fund components of the
Quebec Ministry of Health and Social Services drug subsidy program. The public sector
share of total health expenditure in the Netherlands (67.5%) was slightly lower than in the
above group of six countries, with the social security funds sub-sector accounting for
63.6% of total health expenditure. The three countries with the lowest public sector shares
in descending order are Switzerland (55.6%), Korea (46.2%) and the United States
(44.3%). Among the three countries, the social security funds sub-sector is more important
in Switzerland and Korea, while general governments is the dominant public sub-sector in
the United States.
Figure 40 - Percent of Total Health Expenditure Financed by the Public
Sector, by Source of Finance, Twelve Selected Countries, 2000
Denmark
82.1%
United Kingdom
81.0%
Japan (b)
65.5%
12.5%
France
Hungary
73.5%
2.5%
63.0%
12.7%
68.8%
Germany 6.2%
CANADA (b)
69.5%
Australia (a)
69.8%
4.0%
Netherlands
Korea (a)
63.6%
34.4%
11.8%
United States
0.0%
1.2%
40.5%
15.2%
Switzerland
Public General
Government
Social Security
Schemes
14.9%
29.4%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Source: OECD Health Data 2002, 4th Edition
(a) Data for 1998.
(b) Data for 1999.
Private Sector Sources of Finance—2000
Figure 41 shows the twelve countries in descending order according to the share of total
health expenditure financed by the private sector. In nine countries, private sector funding is
broken down between private insurance and all other private funds. However, this
breakdown is not available for Switzerland, the Netherlands and the United Kingdom.
51
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
Both the United States and Korea had above 50% total health expenditure financed by the
private sector. In contrast to Korea where private insurance funded only 7% of total health
expenditure, private insurance in the United States accounted for more than one third of
total health expenditure, by far the largest proportion of any country. The private sector
funded between 20% to about 30% of total health expenditure in a group of six countries
that includes Australia, Canada, Germany, Hungary, France and Japan. Among the six
countries, the share of total health expenditure financed by private insurance was similar in
Canada, Germany and France, ranging between 11% and 13%. The private insurance share
was a lower in Australia, at 8.1%. It was minimal in Hungary and Japan at a fraction of
1%. Denmark had the lowest proportion of health expenditure financed by the private
sector (18%), only about one tenth of which was funded by private insurance.
Figure 41 - Percent of Total Health Expenditure Financed by the
Private Sector, by Source of Finance, Twelve Selected Countries,
2000
United States
Korea (a)
20.9%
34.8%
46.8%
7.0%
Switzerland
Netherlands
Australia (a)
CANADA (b)
22.0%
8.1%
18.0%
11.2%
Germany
12.5%
Hungary
0.2%
France
Japan (b)
Private Insurance
11.3%
Priv. Funds All Other
24.1%
12.8%
0.3%
12.4%
21.7%
All Private Sources of
Finance
United Kingdom
Denmark
0.0%
1.6%
16.4%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
Source: OECD Health Data 2002, 4th Edition
(a) Data for 1998.
(b) Data for 1999.
# Data Comprehensiveness and Boundaries of Health Care
The OECD System of Health Accounts provides a comprehensive framework for reporting
expenditures on the entire field of health care activities and proposes common functional
boundaries of health care for international comparisons. However, member-countries do not
yet fully report comprehensive data. Also, they may include expenditures that fall outside
the boundaries of health care as defined by the OECD. For OECD Health Data 2002,
countries were asked to provide notes on their departures from OECD/SHA boundaries.
Country-notes are presented below. For each country, the list below shows, under
“Excludes”, expenditures that should have been included in total health expenditure but
were not. It shows, under “Includes”, expenditures that should have been excluded from
total health expenditure but were included.
52
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
A U S T R A L I A
Excludes:
• Minor amounts spent on defense force and prison medical services and expenditure
on school health services.
C A N A D A
Includes:
• Expenditure of Canadian hospitals for care provided to non-Canadians.
• Revenues of Canadian hospitals from ancillary operations (gift shops, parking lots,
etc.). Only profit used to subsidize patient care should be included, however, while
hospital revenues from ancillary operations are reported, profit cannot be determined
from available data.
• Expenditure of inpatient facilities for alcohol/drug addiction.
• Expenditure by the private sector in some long-term residential care facilities
providing mainly room and board and social services (e.g. facilities for mental
retardation, emotionally disturbed children).
Excludes:
• Expenditure on school health made by provincial ministries of education.
• Expenditure by private insurers for out-of-country care provided to Canadians.
• Private sector expenditure on occupational health care.
• Expenditures of voluntary health associations (societies dedicated to prevention and
treatment of major diseases such as arthritis, cancer, diabetes, cerebral palsy, lung,
kidney, liver and heart diseases, etc.).
• Medical expenses by public and private insurance plans for motor vehicle insurance.
D E N M A R K
Excludes:
• Parts of the private health expenditures, e.g. occupational health services,
expenditure by non-profit institutions serving households such as red cross,
philanthropic and charitable institutions.
• Private investments on medical facilities.
F R A N C E
Includes:
• Value of medical goods and services consumed on the national territory, including
expenditure by non-residents.
• May include expenditure on health research and training of health workers.
Excludes:
• May exclude expenditure on medical goods and services consumed by French
residents outside the national territory.
53
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
G E R M A N Y
Excludes:
• Expenditure for military health and prison health.
• Private households’ expenditure on patient transport and nursing care.
H U N G A R Y
Excludes:
• Subsidies by local governments for pharmaceutical goods.
J A P A N
Excludes:
• Some expenditure by central and local governments on administration of health
care services.
• Expenditure made out-of-pocket or by private insurance agents on medical services
not covered by national medical insurance schemes. These include:
- Advanced or experimental medical procedures including clinical trials;
- Acupuncture and other forms of traditional healing;
- Some medical check-ups;
- Upgrade in hotel services for inpatient care;
- Voluntary dental care.
• Expenditures made by private insurance companies to supplement co-payments on
health services covered by the national medical insurance schemes.
• Expenditure made on health insurance to cover medical expenses for residents of
Japan while traveling abroad.
• Expenditures made by non-profit institutions to finance health care to
disadvantaged citizens.
K O R E A
•
No information available on departures from OECD/SHA boundaries and classifications.
N E T H E R L A N D S
Excludes:
• Investments in outpatient care (total and public expenditure do not include gross
capital formation, but do include depreciation and interest as an approximation of the
use of capital goods).
54
NATIONAL HEALTH EXPENDITURE TRENDS O V E R V I E W
U N I T E D
K I N G D O M
Excludes:
• Expenditure on occupational health care, paid household production of health care,
and health expenditure by the armed forces and in prisons.
• Private expenditure on hospital inpatient care. Public expenditure on hospital
inpatient care is for England only. Ratios or per capita calculations carried out
against United Kingdom data or United Kingdom population will therefore be
probably underestimated by about 1/6.
• Private expenditure on outpatient care. Public expenditure on outpatient care is said
to be for England only, yet, public expenditure for physicians’ services and dental
services is said to be for England, Wales, Scotland and Northern Ireland.
• Expenditure on medical specialists is not included in public physician services
expenditure (National Health Service General Medical Services Expenditure). Total
physician services figures are calculated by Department of Health and would include
expenditure on medical specialists.
• A small amount spent on private medicine prescriptions may not be fully taken
into account.
• Expenditure on diagnostic imaging services is said not to be available.
• Private expenditure on patient transport and emergency rescue services. Public
expenditure is for England only.
• Private Expenditure on orthopedic and other prosthetics. Public expenditure is for
England only.
• Expenditure on prevention and public health other than expenditure by National
Health Service on maternal and child health care. Expenditure on maternal and child
health care is available for England only.
U N I T E D
S T A T E S
Excludes:
•
Estimates of “Investment/construction” currently do not include spending for moveable
equipment nor does it include building costs associated with physicians' offices and
other medical offices located in commercial buildings. The US National Health
Expenditure definition for “construction” is limited to the value of new construction put
in place for hospitals and nursing homes (only).
55
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Analytical Focus
Hospital Expenditure by Functional Centre and by Type of
Expense—1976 to 1999
I N T R O D U C T I O N
This year’s analytical focus examines hospital expenditure trends in Canada. The focus
combines data from the Annual Return of Health Care Facilities—Hospitals (HS1&2)19
reported to Statistics Canada until fiscal 1993/1994 with data from the Canadian MIS
Database (CMDB) survey carried out by CIHI since 199520. Data from both surveys were
used to distribute total hospital expenditure reported in NHEX in order to derive estimates
of expenditure by functional centre and type of expense. Expenditure categories are based
on CIHI’s Guidelines for Management Information Systems in Canadian Health Service
Organizations (MIS Guidelines).
CIHI and Statistics Canada carried out a project during 2002 to match data from the
surveys in order to develop a consistent historical series of detailed hospital expenditure
from the mid-1970s to the late-1990s. The surveys are based on different reporting
standards, with the Statistics Canada survey based on the Canadian Hospital Accounting
Manual (CHAM) and the CIHI survey based on the MIS Guidelines developed by CIHI and
provincial ministries of health, which replaced CHAM. In order to match the data as closely
as possible, a matrix of functional centres and types of expense was created and analysts
mapped data variables from each survey into cells of the matrix. The template for the matrix
was based on the MIS Guidelines primary and secondary accounts, which provided a good
fit for most of the CMDB data. Analysts were able to fit variables from the HS1&2 data into
most cells of the matrix but there were some cases where the higher levels of aggregation
in HS1 did not permit as fine a division of data as is the case with CMDB. Nonetheless, CIHI
and Statistics Canada decided to use greater levels of detail for CMDB data in the matrix
where there seemed to be the potential for continuing analytical interest. Future reporting
will follow the MIS Guidelines standard and it seemed appropriate to establish baseline
categories based on possibilities that exist with the MIS Guidelines. Further details about
the data-matching project will be available in a documentation manual, which will be
published by CIHI and Statistics Canada early in 2003.
This analysis contains five sections. Section 1 provides a description of hospital expenditure
trends during 1976/1977 to 1999/2000 and compares survey data to NHEX estimates.
Section 2 discusses expenditures by functional centre and Section 3 discusses expenditures
by type of expense. Section 4 presents a cross-classification of expenditures using the
template developed for the data-matching project. Section 5 presents data by hospital size.
19
20
The Annual Returns were submitted in two parts. Part 1 contained the most detail and was used in this project. Part 2
contained audited information but at higher levels of aggregation.
A comprehensive hospital survey was not fielded in 1994/1995; consequently there is a break in the data in that year.
57
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
S E C T I O N
T R E N D S
1 :
H O S P I T A L
FOCUS
E X P E N D I T U R E
Hospital expenditures in Canada increased from $6.4 billion in 1976 to $26.2 billion in
1994 (Figure 42). Hospital expenditures decreased during the next three years, then
resumed growth in 199721. The period of negative growth in hospital expenditures
coincided with a period of fiscal restraint by provincial and territorial governments, which
saw both health expenditures and other government expenditures decrease22.
Figure 42 - Hospital Expenditure Trends, Canada,
1976 to 1999
($' millions)
30,000
25,000
NHEX
Surveys
20,000
15,000
10,000
5,000
0
1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998
Year
Sources: Canadian Institute for Health Information; Statistics Canada
Hospital survey estimates tend to be close to the NHEX estimates. From 1976 to the end
of the HS1&2 series in 1993/1994, survey estimates were in the range of 90% to 95% of
NHEX estimates in most years. With the transition to CMDB in 1995/1996, survey
estimates ranged from 86% to 91% of the NHEX estimates, with the closest match in
1999/2000. Response rates were somewhat lower in the initial years of CMDB than they
were with the HS1&2 surveys (reporting hospitals accounted for 89% of approved beds in
1995, with the response rate rising to 94% of beds in 1999). A number of factors should
be taken into account when comparing the survey data to NHEX data.
21
22
All trend data reported in this analysis are based on current dollars. At present there is no specific price index for hospital
expenditure. Inflation adjusted data based on the implicit price index for government consumption expenditure (the public
sector price index used in NHEX) shows a flatter expenditure curve than Figure 1 but the trends before and after 1993 are
the same.
For a more thorough analysis of trends in provincial and territorial government expenditures see Provincial/Territorial
Government Health Expenditures, 1974/1975 to 2002/2003, CIHI, Nov. 2002, available at www.cihi.ca
58
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
•
Hospitals included in the HS1&2 surveys consisted of all hospitals controlled by
provincial and territorial ministries of health. Federal and private hospitals are not
included. Although federal and private hospitals are surveyed under CMDB, their data
have been excluded from this analysis to maintain comparability with HS1&2. NHEX
includes all hospitals. There were 761 hospitals with 117,092 beds in Canada at the
time of the 1999/2000 survey, of which ten hospitals with 553 beds were federal
and 14 hospitals with 914 beds were classified as proprietary23.
•
Survey data in Figure 42 have not been extrapolated to estimate expenditure in
non-reporting hospitals.
•
NHEX data are for calendar years while survey data are for fiscal years (e.g. 1996 is
compared to the survey for the fiscal year April 1996 to March 1997).
•
NHEX excludes capital from the hospital expenditure estimates (there is a separate
category in NHEX for capital expenditures). Hospital expenditure surveys include all
expenses except those that are capitalized. The surveys do include some expenses that
are capital related, however, such as amortization and interest on long-term debt.
Capital related expenses were not included in this analysis to avoid double counting of
capital related expenditures in estimates of hospital expenditure based on the hospital
category in NHEX (capital related expenses reported in the1999 survey were
$953 million, equivalent to 3.5% of amounts reported in the survey).
•
NHEX public sector estimates are compiled from public accounts (private sector
estimates are taken from survey data). In some cases long term care program
expenditures could flow to hospitals with long term care units. Long term care
expenditures in public accounts would normally be grouped with expenditure for Other
Institutions (homes for special care) in NHEX, unless such expenditures were explicitly
identified as going to hospitals (or to home care).
The break in the data series between 1993/1994 and 1995/1996 coincided with the
reversal of the trend to annual increases in hospital expenditure. Expenditure declined by
1.8% in 1994, the first decrease in any of the years since the data series began. Hospital
expenditure decreased by another 2.3% in 1995/1996, leading to a compound decrease
of 4.1% between the two survey years. Hospitals would have made a number of
adjustments during this period to deal with reduced revenues. Some of these adjustments
could have taken the form of an acceleration of trends that had begun earlier, such as
reduced number of beds. Hospital beds per thousand population decreased by 20%
between 1993/1994 and 1995/1996 (from 6.0 to 4.8)24, decreases in approved bed
capacity have continued since then, with the reduction from 1993/1994 to 2000/2001
equivalent to 32.2% (Figure 43).
23
24
Canadian MIS Database. Canadian Institute for Health Information.
The number of approved beds may overstate the number of beds staffed and in operation. There has been no national
series for staffed beds since 1993–1994, however. The data on approved beds are compelling even if they may
understate capacity reductions.
59
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 43 - Approved Beds in Hospitals Per Thousand
Population, Canada, 1980/1981 to 2000/2001
8.0
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
80/81
82/83
84/85
86/87
88/89
90/91 92/93 94/95
Year
Sources: Canadian Institute for Health Information; Statistics Canada
96/97
98/99
00/01
Provincial and regional financial restructuring during the 1990s led to closures or mergers
of certain hospitals, which would have been a significant factor in the reduction of
approved bed capacity. Another notable change that had been underway for a number of
years included the conversion of certain procedures from inpatient to day surgery. Other
adjustments would have involved internal expenditures in ways that are not well defined.
Time series data from the surveys should show the extent to which expenditures were
reallocated between functional centres and types of expense. The introduction of a new
reporting standard and new institutional responsibility for the survey creates uncertainties
around the transition period. As a result changes between 1993/1994 and 1995/1996
should be interpreted with caution. In this analysis we have attempted to identify real
changes by examining trends before and after the transition years for consistency or
changes in direction. A decrease/increase in the share of expenditure for a specific cell in
the data matrix between transition years could be considered as reflecting actual changes
in allocation if it was consistent with the trend for that item before and after the transition
years. A stable or increasing/decreasing trend before the transition year followed by
decreases/increases after the transition could be considered to be a reversal of trend if the
direction of change persisted in years that followed the transition year. A simple
reallocation of shares without supporting trend data would be considered as probably
resulting from different survey methodologies.
60
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
S E C T I O N 2 : H O S P I T A L
F U N C T I O N A L C E N T R E
FOCUS
E X P E N D I T U R E
B Y
This section examines hospital expenditure by functional centre. The centre analysis is
based on major categories of the MIS Guidelines Primary Accounts. The accounts define
subdivisions within hospitals to record revenue, expenses and statistics, which pertain to
the function or activity being carried out. Abridged definitions from the MIS Guidelines for
the categories included in this analytical focus are shown below25. It is important to note
that certain service areas, such as diagnostic and therapeutic, normally provide care to
both inpatients and outpatients. Other service areas are predominantly inpatient or
outpatient but provide care to both types of client as required (e.g. inpatients may receive
services in the emergency department in the event of a mishap or for service needs that
are not normally treated within the inpatient department to which they were admitted). As
a result it is not possible to directly observe trends in the balance of inpatient care or
outpatient care and day surgery from these financial data.
# Administrative Services
Functional centres that generally support administering the health service organization.
Examples include finance, human resources, systems support and telecommunications.
# Support Services
Functional centres that generally support the other functional centres within the health
service organization. Examples include materiel management, plant maintenance.
# Nursing Inpatient Services
Operating Room is typically included under Nursing Inpatient Services in the
MIS Guidelines. For this analysis it has been removed and is reported separately.
Nursing services provided to inpatients to meet their physical and psychosocial
needs, including:
•
Ambulatory care clients receiving services in nursing inpatient units if separate
ambulatory care functional centres have not been established for these services.
•
Direct expense for physicians contracted by the health service organization to provide
services within a specific nursing inpatient and resident functional centre.
# Operating Room
Units specifically designed, staffed and equipped for the provision of services to patients
during surgical intervention. Includes data for surgical day/night patients who receive
services in this unit. In the analytical framework used for this project operating room
expenses consist of expenses reported for operating rooms and post-anaesthetic
recovery rooms.
25
Source: MIS Guidelines 2002—Glossary of Terms. CIHI Ottawa.
61
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
# Ambulatory Care Services
Emergency services are typically included under Ambulatory Care Services in the
MIS Guidelines. For this analysis it has been removed and is reported separately.
Specialized diagnostic, consultative, treatment, and teaching services provided primarily for
registered clients. These services are generally provided in a hospital setting. Excludes:
•
services provided to ambulatory care patients by personnel who are accountable to and
charged to Nursing Inpatient or Diagnostic and Therapeutic Services; or
•
primary care and supportive services (e.g. public health clinics, home care programs,
health promotion/education) provided to clients of Community and Social Services.
# Emergency
The unit provides assessment, diagnostic and treatment services to individuals with
conditions requiring immediate attention. Includes data for services provided for registered
scheduled outpatients/clients receiving care in Emergency.
# Diagnostic and Therapeutic Services
Diagnostic services include professional and technical services which assist in the clinical
investigation … either to detect the presence of disease, disability, or injury or to assess
the severity of known disease, disability, or injury.
Therapeutic services include professional and technical services provided to inpatients,
residents or clients which assist in the alleviation or cure of the causes, symptoms and/or
sequelae of disease, disability or injury.
Excludes professional and technical services provided by personnel who are accountable
and charged to Nursing Inpatient Services in the functional centre framework.
# Community and Social Services
Health and social services provided by the hospital on an ambulatory or out-reach basis to
individuals, groups and/or communities. (e.g. primary care, prevention, wellness, etc.).
Services provided by regional health authorities independent of hospitals are not included.
# Research and Education
Research—Overall management and operational support of formally organized research
undertaken by the health service organization.
Education—In-service education programs to health service organization personnel, as well
as formal education programs to undergraduate and post-graduate technical, professional
and medical students/trainees.
62
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
# All Other
Includes undistributed expenses in the MIS Guidelines. Most of these expenses cannot
be associated directly with patient care and include items such as non-patient food
services, ancillary operations, transportation, capital fund and special purpose fund.
Unallocated administrative expenses such as taxes, depreciation and amortization are
also included in this category. There are no expenses allocated to the All Other category
in the HS1&2 data.
# Functional Centre Distributions in HS1&2 and CMDB
Distributions of expenditures by functional centre were quite similar under HS1&2 in
1993/1994 and CMDB in 1995/1996 (Table 9, Figure 44). One important difference was
the addition of the All Other category in CMDB, which accounted for approximately four
percent of hospital expenditures. In HS1&2 many of these expenditures are believed to
have been allocated to the Administrative Services category. It is also worth noting that
the convention of excluding capital related expenses in this analysis reduces the weight of
All Other expenditures, since capital related expenses tend to be the largest expense item
in the All Other category.
Operating room, ambulatory care services and emergency increased in CMDB in
1995/1996 relative to HS1&2 two years earlier. These functional centres were receiving
an increasing share of expenditures in prior years, however, and continued to receive
higher shares in subsequent years. Increases in these categories between the two surveys
appear for the most part to reflect a trend in restructuring of the ways in which care is
delivered. There might also be an effect arising from the existence of more detailed
categories in the MIS Guidelines. The shares of other categories decreased. Trends in
category allocations are discussed in greater detail in the sections that follow.
Table 9—Hospital Expenditure and the Percentage Distributions
by Functional Centre, Canada
Functional Centres
Administrative Services
Support Services
Nursing Inpatient Services
Operating Room
Ambulatory Care Services
Emergency
Diagnostic & Therapeutic
Community & Social Services
Research & Education
All Other
Total
Expenditure 1999
Percentage Distributions (%)
1993/1994 1995/1996 1998/1999 1999/2000
($' millions)
2,404.7
4,849.5
8,790.2
1,680.9
1,876.5
1,235.1
5,580.1
453.4
684.4
1,163.3
9.3
22.1
30.6
5.2
4.6
3.0
21.9
0.1
3.1
---
6.5
21.4
29.9
6.5
5.9
3.2
20.0
--2.6
3.9
7.2
18.4
29.4
6.8
7.0
3.7
19.8
0.4
2.7
4.7
8.4
16.9
30.6
5.9
6.5
4.3
19.4
1.6
2.4
4.1
28,718.1
100.0
100.0
100.0
100.0
Sources: Canadian Institute for Health Information; Statistics Canada
63
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 44 - Distribution of Hospital Expenditure
by Functional Centre, Canada
35.0%
30.0%
25.0%
20.0%
1993
1995
15.0%
10.0%
5.0%
0.0%
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era
h&
Ca
&
pp
ati
So
tra
Op
ry
Su
arc
ti c
Inp
&
o
e
nis
s
t
i
s
g
o
la
m
n
ity
Re
gn
bu
rs i
un
Ad
Di a
Nu
Am
mm
o
C
Sources: Canadian Institute for Health Information; Statistics Canada
# Trends 1976 to 2000
Administration and Support Services
Administration has increased its share of hospital expenditure. The trend from 1976 to
1993 shows a gradual increase with variations upward and downward from year to year
(Figure 45). Administration’s share in the HS1&2 survey peaked at 9.7% in 1990 and
1991. The transition to the CMDB resulted in a one-time drop of 2.8 percentage points,
which is believed to be due largely to the reclassification of certain expenses under the
MIS Guidelines. Between 1995 and 1999 administration expenditures increased at an
average rate of 9.9%, with the largest increases in the areas of communications, systems
support and general administration (Table 10). These data provide a highly aggregate
overview, but they suggest that the trend to hospital mergers and closures associated with
financial restructuring may have contributed to above average increases in administrative
expense during the latter half of the 1990s.
The share of hospital expenditure allocated to support services has declined during the last
24 years, dropping from 27% in 1976 to 17% in 1999—the largest decline in share of any
category. The decline has been steeper than normal during the years since 1995, dropping
4.5 percentage points in four years. A closer examination of the data shows an absolute
decline in expenditure for support services during the four years (an annual rate of –2.9%),
with decreases in all areas except patient transport.
64
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Table 10—Expenditure Weights and Annual Rates of Increase,
Administrative and Support Services, Canada
MIS Account Numbers and Name
Expenditure 1999
($' millions)
Annual Rate of
Increase Since 1995
Administrative Services
71110
71115
71120
71125
71130
General Administration
Finance
Human Resources
Systems Support
Communications
Total
1,081
223
251
505
345
2,405
9.6%
-3.8%
5.9%
11.9%
25.6%
9.5%
470
21
829
301
-2.2%
-2.1%
-1.8%
-5.4%
687
119
696
77
154
163
303
1,030
4,850
-1.1%
-0.6%
-0.5%
-2.1%
-17.0%
3.6%
-6.9%
-3.1%
-3.0%
Support Services
71135
71140
71145
71150
Materiel Management
Volunteer Services
Housekeeping
Laundry & Linen
Plant Administration
71153, 55 and Operation
71160
Plant Security
71165
Plant Maintenance
71175
Bio-Medical Engineering
71180, 82 Registration
71185
Patient Transport
71190
Health Records
71195
Patient Food Services
Total
All Hospital Expenditures
28,718.1
2.9%
Source: Canadian Institute for Health Information
Nursing Inpatient Services
Nursing inpatient services is the largest broad functional center grouping. Its share of total
expenditures trended downward from a high of 33.8% in 1980 to 30.6% in 1993
(Figure 46). Since 1995, the share of nursing inpatient services has been relatively stable
at approximately 30%. There was an increase of 1.2 percentage points in the nursing
inpatient services share in 1999. The increase was unusual in the context of past trends
and it is not clear if it marks a turning point in the share of this category or a temporary
aberration in the trend. The question is highly relevant given that 1.2 percentage points
represent approximately $345 million in hospital expenditure.
Nursing inpatient services is broken down in CMDB into more discrete functional centres
such as medical, surgical, obstetrics, pediatrics, psychiatry; and long term care,
rehabilitation and intensive care. This analysis does not delve further into the specific
functional centres but the database provides an opportunity to study trends for these types
of care. The range of functional centres included demonstrates that there is a wide range
of expenditures within the nursing inpatient services functional centre including other
occupational groups and other related expenses.
65
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
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Operating Room
Operating room expenditures have increased their share of hospital expenditure modestly
(from 4.5% to 5.2% during 1976 to 1993 and from 6.5% to 6.8% during 1995 to 1998).
There also appears to have been a transition effect between 1993 and 1995, and an
unusual departure from trend during 1999 (Figure 47).
Ambulatory Care Services and Emergency
Ambulatory care services and emergency have both increased their shares of hospital
expenditure, with steeper trend curves since 1995 than in the earlier years of the analysis
(Figure 48). Ambulatory care had a drop of 0.5 percentage points in 1999 while
emergency care had an increase of 0.6 percentage points. Both rates of change seemed
larger than normal (and a reversal of the direction of the past trend in the case of
ambulatory care). There may have been a transition effect in reporting ambulatory care
between 1993 and 1995, as there was a relatively large increase (1.2 percentage points)
between the two years.
Diagnostic and Therapeutic Services
Diagnostic and therapeutic services increased modestly from 18% of hospital expenditures
in 1976 to 22% in 1993 (Figure 49). The share dropped by 1.9 percentage points from
1993 to 1995 and it has been declining slightly since then.
Community and Social Services, Research and Education
Community and social services has accounted for a very small share of hospital
expenditure historically. Prior to 1995 the only expenditure in this category was for
community based home care. Hospitals have been providing a broader range of community
based services in recent years and the share of this category is growing.
Research and education has been quite stable, fluctuating in a narrow range around three
percent of expenditures from 1976 to 1993, and at 2.4% to 2.7% since 1995.
Figure 45 - Share of Hospital Expenditure by Selected
Functional Centres, Canada, 1976/1977 to 1999/2000
30.0%
25.0%
20.0%
15.0%
Administrative Services
Support Services
10.0%
5.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
66
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
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Figure 46 - Share of Hospital Expenditure by Selected
Functional Centre, Canada, 1976/1977 to 1999/2000
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
Nursing Inpatient Services
10.0%
5.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
Figure 47 - Share of Hospital Expenditure by Selected
Functional Centres, Canada, 1976/1977 to 1999/2000
10.0%
8.0%
6.0%
Operating Room
4.0%
2.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
67
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 48 - Share of Hospital Expenditure by Selected
Functional Centres, Canada, 1976/1977 to 1999/2000
10.0%
8.0%
6.0%
Ambulatory Care Services
Emergency
4.0%
2.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
Figure 49 - Share of Hospital Expenditure by Selected
Functional Centre, Canada, 1976/1977 to 1999/2000
30.0%
25.0%
20.0%
15.0%
10.0%
Diagnostic & Therapeutic
5.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
68
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
S E C T I O N
T Y P E O F
3 : H O S P I T A L
E X P E N S E
FOCUS
E X P E N D I T U R E
B Y
The second view of hospital expenditures is the most traditional—expenditures by type of
expense. Categories used in this analysis include:
•
Physicians’ services reimbursed directly by hospitals. This category includes physicians
employed or contracted by the hospital. It is important to note that most physicians’
services are paid directly by provincial governments and would not be included in hospital
expenditures even though the service took place in a hospital (e.g. most surgery).
•
Gross salaries for hospital staff other than physicians. This would include medical
professionals such as nurses; staff providing hotel services such as food service and
cleaning; and administrative staff.
•
Benefits, including government programs such as Canada Pension, employment
insurance, workers compensation; life and health insurance; termination benefits
and perquisites.
•
Drugs purchased by the hospital.
•
Medical supplies used in treating patients, such as medical instruments and sutures.
•
Non-medical supplies such as food and general supplies used to maintain the
hospital premises.
•
Sundries, which include non-medical professional services (e.g. legal and accounting),
rent and data processing.
•
Expenses for amortization and interest on long term debt are not included for purposes
of this analysis as they are considered to be capital related expenses that would usually
be counted under the broad category of Capital in national health expenditures.
Services contracted out to private providers are recorded differently in the CMDB and
HS1&2 databases. CMDB includes an account for purchased salaries or fees, which
includes services contracted out26. In HS1&2 contracted services would normally have
been recorded in the account, ‘Other supplies and expenses’.
# Expense Distributions in HS 1&2 and CMDB
The distribution of most expense categories was quite similar under HS1&2 in 1993/1994
and CMDB in 1995/1996 (Figure 50). Physicians’ services expenditure was higher under
CMDB. Two differences in recording expenditure for physician services would have been
partially responsible for the increase in physicians’ share of expenditure: 1) CMDB includes
salaries of residents, interns and medical students as physician expenditure while these
expenses would be allocated to other staff salaries in HS1&2; 2) most physician
expenditure is recorded as purchased services in CMDB—purchased services represented
57% of total physician compensation in 1995/1996 and 71% in 1999/2000. It is possible
that some physician payments by hospitals (e.g. fee-for-service or sessional fees) could
have been recorded as other supplies and sundries in HS1&2.
26
For example, salaries paid by contractors who provide security or housekeeping services would be recorded
as purchased salaries.
69
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
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The accounts for other supplies and sundries in HS1&2 included some amounts that are
distributed to other functional centres in CMDB. Other supplies and sundries were not
separate categories in HS1&2 and efforts to separate specific components during the datamatching project were unsuccessful. For purposes of this analysis, two categories in
CMDB data but one combined category for time series analysis of the data series from
1976 to 1999 were used.
# Trends 1976 to 2000
Physician compensation represented 3.3% of hospital expenditures in 1976 but dropped to
2.3% in 1979 (Figure 51). The share increased slowly during the 1980s, stabilizing at
2.7%, but has been more variable in CMDB, ranging from 4.0% to 4.6%.
Staff salaries and benefits together accounted for 76.3% of hospital expenses in 1976.
The share for these expenses declined throughout the 1980s and 1990s (Figure 52). The
combined share in 1993 was 71.3% and in 1999 it was 68.7%. Salaries declined while
benefits increased their share of expenditure. Benefits appear to have stabilized at
approximately 11% of total expenses during the 1990s, while the share of salaries
continues to decline. The ratio of salaries to benefits in 1999 was 83.8% to 16.2%.
Drugs accounted for an increasing share of hospital expenditure from 1980 to 1986. From
1986 to 1993 the share of drugs remained between 3.1% and 3.3% (Figure 53). Drug
expenditures have been increasing since 1995, from 3.5% to 4.3% of hospital expenses.
Despite the increase in recent years, drug expenditures by hospitals have not followed the
trend for drugs purchased outside of the institutional setting, which increased from 8.5%
of health expenditures in 1976 to 15.0% in 199927.
The share of expenses for medical supplies is quite similar to the share for drugs with
HS1&2, medical supplies peaked at 4.2% of expenses in 1986 then declined to 3.7% in
1993. The share of medical supplies is higher under CMDB (presumably some expenses
have moved from supplies and sundries to medical supplies under the MIS Guidelines).
Medical supplies have increased from 5.1% of expenditures in 1995 to 6.4% in 1999.
Supplies and sundries have followed a variable trend, peaking at 19.9% of hospital
expenses in 1989 (Figure 54). There was a break in the series between the surveys, as
some expenses were assigned to different categories under the MIS Guidelines. The trend
since 1995 shows supplies and sundries increasing quite rapidly (from 14.4% in 1995 to
16.7% in 1999). Most of the increase in the share of the combined categories is
accounted for by sundries, which increased in share from 4.7% in 1995 to 6.6% in 1999.
27
See discussion in the section of this publication titled, Total Health Expenditure by Use of Funds. In the NHEX total
expenditure series, Drugs do not include products supplied to institutional inpatients. Instead, all expenses of institutions
are classified as Hospital or Other Institutions expenditure.
70
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 50 - Distribution of Hospital Expenditure
by Type of Expense, Canada
70.0%
1993
1995
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Physician
Compensation
Salaries
Benefits
Drugs
Medical
Supplies
Other Supplies
& Sundries
Sources: Canadian Institute for Health Information; Statistics Canada
Figure 51 - Share of Hospital Expenditure by Selected Type of
Expense, Canada, 1976/1977 to 1999/2000
10.0%
8.0%
6.0%
Physician Compensation
4.0%
2.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
71
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 52 - Share of Hospital Expenditure by Selected Types of
Expense, Canada, 1976/1977 to 1999/2000
80.0%
60.0%
40.0%
Benefits
Salaries
20.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
Figure 53 - Share of Hospital Expenditure by Selected Types of
Expense, Canada, 1976/1977 to 1999/2000
10.0%
8.0%
6.0%
Drugs
Medical Supplies
4.0%
2.0%
0.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
72
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 54 - Share of Hospital Expenditure by Selected Types of
Expense, Canada, 1976/1977 to 1999/2000
22.0%
20.0%
18.0%
Other Supplies & Sundries
16.0%
14.0%
12.0%
76/77 78/79 80/81 82/83 84/85 86/87 88/89 90/91 92/93 94/95 96/97 98/99
Year
Sources: Canadian Institute for Health Information; Statistics Canada
S E C T I O N 4 : H O S P I T A L E X P E N D I T U R E
B Y F U N C T I O N A L C E N T R E A N D T Y P E
O F E X P E N S E
Table 11 provides a cross-classification of hospital expenditure in 1999, showing how
expenses for each functional centre are allocated to each of the different types
of expense.
•
Physician compensation is concentrated in diagnostic and therapeutic functional centres
reflecting the fact that many physicians in the specialties of radiology and pathology
receive remuneration from hospitals.
•
Other staff salaries and benefits are the largest item of expenditure in all functional
centres except all other (undistributed amounts). Other staff salaries are concentrated
in nursing inpatient, diagnostic and therapeutic and support services.
•
Approximately half of drugs expenditures are found in nursing inpatient and diagnostic
and therapeutic functional centres.
•
Medical supplies are concentrated in operating room, diagnostic and therapeutic and
nursing inpatient functional centres.
•
Other supplies and sundries are concentrated in support, diagnostic and therapeutic and
the other (undistributed) and functional centres.
73
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Table 11—Hospital Expenditure by Functional Centre and
Type of Expense, Canada, 1999
($millions)
Functional Centre
Administrative Services
Support Services
Nursing Inpatient Services
Operating Room
Ambulatory Care Services
Emergency
Diagnostic & Therapeutic
Community & Social Services
Research & Education
All Other
Total
Physician
Compensation
Salaries &
Benefits
Drugs
Other
Medical
Supplies &
Supplies
Sundries
Total
67.8
3.2
227.4
10.0
74.7
80.9
608.4
14.8
36.0
9.9
1,526.4
3,032.4
7,511.9
802.2
1,251.0
970.1
3,510.0
243.3
433.4
453.0
30.5
78.8
317.6
89.2
168.2
56.6
296.0
83.9
19.3
82.0
72.1
203.8
299.3
592.4
191.1
65.0
311.2
43.3
46.8
16.5
707.9
1,531.4
434.0
187.1
191.5
62.4
854.5
68.2
148.8
601.9
2,404.7
4,849.5
8,790.2
1,680.9
1,876.5
1,235.1
5,580.1
453.4
684.4
1,163.3
1,133.1
19,733.7
1,222.3
1,841.4
4,787.7
28,718.1
Source: Canadian Institute for Health Information
Trends by Functional Centre and Type of Expense
It is possible to track trends by functional centre and type of expense with CMDB data. In
the HS1&2 data, staff benefits, medical supplies and drugs were not reported by functional
centre. In order to estimate total expenses by functional centre for this study, the
distribution of these three types of expense were estimated using their distribution in
CMDB in 1995. Physician expenses reported in HS1&2 could be mapped to most
functional categories but not to nursing inpatient or operating room functional centres.
These survey differences limit the scope for comparing trends in expenditures within
specific functional centres and expense types. In the discussion that follows, the analysis
has been limited to the ambulatory care and emergency functional centres and a combined
salary and benefits expense category.
The estimated distribution of salary and benefits are shown for 1989 and 1999 in
Figure 55. The percent of salaries and benefits accounted for by administration and
support and nursing inpatient declined over the ten year period while the percent
accounted for by ambulatory care and emergency increased.
Within the ambulatory care functional centre, expenditures for physicians’ services and
other salaries and benefits increased as a share of the total during the ten year period while
expenditures for medical supplies and drugs decreased (Figure 56). This trend suggests
that health human resources are now more predominant in the cost of hospital ambulatory
care than they were ten years ago.
In emergency departments, physicians’ services increased from 2.4% to 6.0% of
expenditure during the ten year period, perhaps reflecting the increasing tendency for
emergency physicians to be remunerated on a sessional basis rather than paid fee-for-
74
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
service28. The share of other staff salaries and benefits decreased by 2.3 percentage points
while the remaining categories decreased slightly or remained approximately the same
(Figure 57).
Figure 55 - Distribution of Salaries and Benefits, Canada
50.0%
1989
1999
40.0%
30.0%
20.0%
10.0%
0.0%
ic
t
C are
tie nt
enc y
R oo m
peut
ppor
I npa
me rg
hera
ting
at ory
l
& Su
g
E
a
T
u
r
in
e
b
in
s
&
p
O
ic
Am
N ur
A dm
n o st
D iag
r
Ot he
Sources: Canadian Institute for Health Information; Statistics Canada
Figure 56 - Distribution of Ambulatory Care Expense, Canada
80.0%
70.0%
60.0%
50.0%
1989
1999
40.0%
30.0%
20.0%
10.0%
0.0%
Physician
Compensation
Salaries &
Benefits
Drugs
Medical Supplies Other Supplies &
Sundries
Sources: Canadian Institute for Health Information; Statistics Canada
28
This explanation should be viewed with caution. Although alternatives to fee-for-service remuneration have grown in
emergency medicine in most provinces, there are a variety of administrative arrangements and the extent to which
payments flow through hospital budgets (versus direct provincial or health region payments) is not clear.
75
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 57 - Distribution of Emergency Care Expense, Canada
80.0%
70.0%
60.0%
50.0%
1989
1999
40.0%
30.0%
20.0%
10.0%
0.0%
Physician
Compensation
Salaries &
Benefits
Drugs
Medical Supplies Other Supplies &
Sundries
Sources: Canadian Institute for Health Information; Statistics Canada
S E C T I O N 5 : H O S P I T A L
H O S P I T A L S I Z E
E X P E N D I T U R E
B Y
This section examines hospital expenditure between 1995 and 1999 by hospital peer
group. These comparisons are from CMDB. Data by peer group have not yet been
produced from HS1&2, although they are expected to be available by year end. Most peer
groups are based on number of hospital beds, except for pediatric and teaching hospitals.
For the purpose of this analysis Peer groups are:
•
< 50 beds
•
50 to 99 beds
•
100 to 199 beds
•
200 to 299 beds
•
300 to 399 beds
•
400+ beds
•
Pediatric hospitals
•
Teaching hospitals
Between 1995 and 1999, the shares of hospital expenditure accounted for by teaching
hospitals and hospitals with over 400 beds increased by over 2 percentage points each
(Figure 58). Hospitals with fewer than 50 beds increased their share by 0.8 percentage
points. Hospitals in the other peer groups tended to have a declining share, with the largest
drop (2.5 percentage points) in hospitals with 300–399 beds.
76
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Combining the first two peer groups, hospitals with less than 99 beds accounted for
almost the same share of expenditure as hospitals in each of the next two size categories
during 1999 (10.3% to 11.6%). At the other end of the peer group scale, the combined
share of hospitals with over 400 beds and teaching hospitals was 58.9%. Teaching
hospitals accounted for 39.4%, slightly more than double the share of hospitals with
400 or more beds (19.5%). To put the share of teaching hospitals in context, Canada’s 53
teaching hospitals accounted for 7.0% of all hospitals in operation and 25.9% of beds in
1999.
Estimated expenditure in 1999 for all hospitals in Canada was $28.7 billion. Expenditure
increased by 12.0% between 1995 and 1999. Expenditure trends were quite different
by hospital peer group, with expenditure decreasing for hospitals with 50–99 beds,
300–399 beds and pediatric hospitals (Table 12). Hospitals with 400 or more beds
accounted for $1.2 billion of the total $3.1 billion increase. Some of the rates of
change have been associated with changes in the number of approved beds (Table 13)
while others would be due to more complex factors that would require additional research
to explain.
Figure 58 - Share of Expenditure by Hospital Peer Group,
Canada
40.0%
35.0%
30.0%
1995
1999
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
<50 Beds
50-99
Beds
100-199
Beds
200-299
Beds
Source: Canadian Institute for Health Information
77
300-399
Beds
400+
Beds
Pediatric
Teaching
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Table 12—Estimated Hospital Expenditure by Peer Group29, Canada, 1995 and 1999
($millions)
Hospital Peer Group
1995
<50 beds
50 - 99 beds
100 - 199 beds
200 - 299 beds
300 - 399 beds
400+ beds
Pediatric hospitals
Teaching hospitals
Total
Percent
Change
1999
1,103
1,693
2,962
2,973
2,309
4,438
609
9,558
1,462
1,581
2,962
3,331
1,874
5,606
586
11,316
32.5%
-6.6%
0.0%
12.0%
-18.8%
26.3%
-3.7%
18.4%
25,645
28,718
12.0%
Source: Canadian Institute for Health Information
Table 13—Hospitals and Beds in Operation, Canada, 1995 and 1999
1995
Hospital Peer Group
1999
Hospitals
Beds
Hospitals
Percent
Change in
Beds
Beds
<50 beds
50 - 99 beds
100 - 199 beds
200 - 299 beds
300 - 399 beds
400+ beds
Pediatric hospitals
Teaching hospitals
342
167
125
83
46
46
8
62
8,707
11,578
17,553
20,741
15,254
30,349
2,091
35,940
346
120
100
61
25
50
6
53
8,470
8,140
14,293
14,931
8,452
30,978
1,482
30,346
-2.7%
-29.7%
-18.6%
-28.0%
-44.6%
2.1%
-29.1%
-15.6%
Total
879
142,213
761
117,092
-17.7%
Source: Canadian Institute for Health Information
29
Expenditure was estimated by a two step procedure:
1. Survey amounts were divided by beds in reporting hospitals and the result was multiplied by beds in operation.
2. Percentage shares were calculated from the results of step 1 and used to distribute hospital expenditure reported
in the National Health Expenditure Database.
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NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
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# Distribution of Expenditures by Functional Centre
There are clear variations in the patterns of expenditure by hospital peer group. Table 14
shows the percentage distribution of expenditures across functional centres in 1999.
•
Administrative costs are quite consistent among the peer groups at 8.6% to 8.9% of
hospital expenditure.
•
Support services are lowest as a percent of expenditure in teaching and pediatric
hospitals. Support services appear to be inversely related to hospital size, increasing
from a low of 14.0% in pediatric hospitals to a high of 23.2% in hospitals with fewer
than 50 beds.
•
Nursing inpatient services are lowest as a percent of expenditure in teaching and
pediatric hospitals. They vary within a range of 3.3 percentage points in peer groups
with 100 to over 400 beds, and reach a high of over 36% in hospitals with less than
50 beds. The relatively high percentage in the lowest bed category probably reflects a
concentration on nursing care in the smaller hospitals.
•
Operating room expenses account for a higher share of expenditure in teaching hospitals
and hospitals in the range of 100 to 399 beds than in the other four peer groups.
•
Ambulatory care accounts for 10.2% of pediatric hospital costs, and 7.6% of teaching
hospital costs. The share of ambulatory care for the groups under 400 beds declines
inversely with peer group bed size, reaching a low of 3.5% in the smallest hospitals.
•
Emergency room expenses are highest as a share of expenditure in hospitals with fewer
than 100 beds and lowest in teaching hospitals.
•
Diagnostic and therapeutic services range from about 18% to 22% of hospital costs
except in the under 50 bed size, where they drop to about 15%.
•
Community and social services have the highest share of expenditure in teaching
hospitals, while research and education shares are highest in teaching and
pediatric hospitals.
Table 14—Distribution of Hospital Expenditure
by Peer Group and Functional Centre, Canada, 1999
Functional Centre
Administrative Services
Support Services
Nursing Inpatient Services
Operating Room
Ambulatory Care Services
Emergency
Diagnostic & Therapeutic
Community & Social Services
Research & Education
All Other
Total
< 50
Beds
Type of Hospital
50 - 99 100-199 200-299 300-399
Beds
Beds
Beds
Beds
400+
Beds
Pediatric
Teaching
8.9%
23.2%
36.4%
1.5%
3.5%
5.8%
14.9%
1.4%
0.3%
4.1%
8.6%
21.6%
32.5%
3.9%
4.8%
6.3%
18.2%
1.1%
0.5%
2.5%
8.8%
18.9%
30.3%
6.3%
5.2%
5.6%
19.5%
0.5%
1.0%
3.7%
8.7%
18.1%
31.8%
6.4%
5.9%
5.0%
19.5%
0.4%
0.6%
3.7%
8.8%
16.7%
31.6%
6.6%
6.6%
4.9%
20.3%
0.6%
0.7%
3.2%
8.7%
17.3%
33.6%
5.4%
6.0%
4.2%
18.3%
1.3%
1.3%
3.9%
8.6%
14.0%
25.7%
5.2%
10.2%
3.7%
21.7%
0.8%
5.8%
4.3%
8.0%
14.7%
28.2%
6.4%
7.6%
3.3%
20.3%
2.6%
4.3%
4.7%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
Source: Canadian Institute for Health Information
79
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
The findings discussed above should not be interpreted as reflecting relative expenditure
across peer groups. Expenditure per bed or per case could show different rankings than the
comparisons of shares of expenditure allocated to each functional category. Certain types
of care would be more expensive in some types of hospital than in others. Usage patterns
will also affect comparisons based on utilization and expenditure—for example hospitals
with fewer than 50 beds account for 13.4% of all emergency care visits although they are
responsible for less than 5% of hospital expenditure30.
# Trends 1995 to 1999
This section examines trends by peer group in the shares of four functional centres that
were changing in clearly defined ways over time when viewed from the perspective of all
hospital expenditure (see Section 2). These functional centres are administrative, support,
ambulatory care services and emergency.
Administrative Services
All peer groups except hospitals with fewer than 50 beds showed increases in the share of
expenditures allocated to administration between 1995 and 1999 (Figure 59). The share of
administration expenditure in each of the peer groups was much more even in 1999 than
in 1995.
Support Services
All peer groups experienced reductions in the share of expenditures accounted for by
support services (Figure 60). Reductions were in the range of 4.6 to 6 percentage points
for pediatric hospitals and hospitals in the 100 to 400+ size groups.
Ambulatory Care Services
The percentage of expenditures accounted for by ambulatory care increased modestly
(0.7 to 1.9 percentage points) for all peer groups except teaching hospitals (Figure 61).
Emergency
Hospitals of all size groups increased their share of expenditures for the emergency
functional centre (Figure 62). Increases were largest in the two lowest bed size
categories. The profile by peer group changed noticeably, with the 1999 profile indicating
a clearly inverse relationship between hospital size and the percent of budgets spent for
emergency services.
The analysis of changes for the functional centres discussed above show that there have
been systematic changes in hospital expenditure profiles during the last five years. The
direction of change is, almost without exception, similar for hospitals in all peer groups,
which indicates that changes in total expenditure were not just the result of a
reorganization of hospitals due to hospital closures and mergers. While analysis at this level
and within this somewhat limited timeframe allows only tentative conclusions, it provides
evidence of a reallocation of hospital expenditures during the last half of the
30
Utilization data from the CMDB were used in this brief discussion. The utilization statistics were not studied in any detail
during this analysis. CIHI has developed other analytical tools to study cost and utilization, such as the Cost per Weighted
Case methodology, which assigns average cost to inpatient cases weighted by case complexity.
80
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
1990s in ways that reflect administrative policy decisions. Changes in the costs of the
factors of production in hospital care would also have affected expenditure trends and the
relative roles of management decisions and underlying factor cost trends are not clear from
this level of analysis.
C O N C L U S I O N S
The joint project by CIHI and Statistics Canada to match historical data from the HS1&2
and CMDB surveys has resulted in a consistent time series of financial data for Canadian
hospitals. During the 24 years covered by this analysis there were clear trends in the
distribution of hospital expenditures across functional centres and types of expense. These
trends were consistent for hospitals irrespective of number of beds, or status as pediatric
or teaching hospitals.
There has been a substantial reduction in the shares of expenditure accounted for by
support services and nursing inpatient services. The share of budgets allocated to
administration has increased during the period of financial restructuring in the late 1990s.
The share of expenditure for ambulatory care and emergency has increased steadily since
the early 1980s. Expenditures for operating rooms and diagnostic and therapeutic services
have maintained a fairly steady share of hospital budgets.
In the expense categories, salaries and benefits have declined in aggregate as a share of
hospital budgets, although benefits have increased; salary and benefits together account
for over two-thirds of total hospital expenditure. Drugs and medical supplies have
increased their shares of hospital expenditure although rates of increase in the share of
drugs have been considerably less in hospitals than in total health spending.
There has been a shift in the breakdown of hospital expenditure by peer group during the
last half of the 1990s to larger institutions, particularly hospitals with 400 or more beds
and teaching hospitals. Hospital peer groups show interesting differences in the distribution
of care by functional centre, indicating that the financial importance of different types of
care is affected by a hospitals’ role in the health care system. Trends in the late 1990s
appear to provide clear evidence of a shift in the composition of hospital expenditures
consistent with the evolution of administrative policy.
81
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 59 - Administrative Services as a Percent of Hospital
Expenditure, Canada
9.0%
8.0%
7.0%
6.0%
5.0%
4.0%
1995
1999
3.0%
2.0%
1.0%
0.0%
<50
Beds
50-99
Beds
100-199 200-299 300-399
Beds
Beds
Beds
400+
Beds
Pediatric Teaching
Peer Group
Source: Canadian Institute for Health Information
Figure 60 - Support Services as a Percent of Hospital
Expenditure, Canada
25.0%
1995
1999
20.0%
15.0%
10.0%
5.0%
0.0%
<50
Beds
50-99
Beds
100-199 200-299 300-399
Beds
Beds
Beds
Peer Group
Sources: Canadian Institute for Health Information
82
400+
Beds
Pediatric Teaching
NATIONAL HEALTH EXPENDITURE TRENDS A N A L Y T I C A L
FOCUS
Figure 61 - Ambulatory Care Services as a Percent of Hospital
Expenditure, Canada
10.0%
1995
1999
8.0%
6.0%
4.0%
2.0%
0.0%
<50
Beds
50-99
Beds
100-199 200-299 300-399
Beds
Beds
Beds
400+
Beds
Pediatric Teaching
Peer Group
Source: Canadian Institute for Health Information
Figure 62 - Emergency Care Services as a Percent of Hospital
Expenditure, Canada
6.0%
1995
1999
4.0%
2.0%
0.0%
<50 Beds
50-99
Beds
100-199
Beds
200-299 300-399
Beds
Beds
Peer Group
Source: Canadian Institute for Health Information
83
400+
Beds
Pediatric
Teaching
NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
STUDIES
National Health Expenditure Database—
Roadmap Feasibility Studies
P R O J E C T
G O A L
A N D
S C O P E
In 1999, CIHI, Statistics Canada and other partners began the Roadmap Initiative—a series
of projects to improve and modernize Canada’s health information system and
infrastructure. The goal for the National Health Expenditure component of the Roadmap
Initiative was to make enhancements to the National Health Expenditure Database (NHEX)
to ensure its continued relevance and usefulness in supporting accurate macro level
analysis of Canadian health spending.
The scope of the NHEX roadmap project included an assessment of the existing database,
including data quality and level of detail. Information development followed two broad
streams of closely related activity:
1. Identify current and emerging issues and assess the feasibility of expanding health
expenditure data to provide relevant information to meet user needs.
2. Identify data quality issues in the current database, prioritize and implement required
changes where possible.
A series of feasibility studies were conducted to determine the advisability and possibility
of expanding estimates in the NHEX database for a number of priority issues. Each study
sought to provide clear definitions of the subject area, define the degree of present
reporting in NHEX and identify data sources for enhanced reporting. This note summarizes
the major projects and feasibility studies completed to date31.
P R O V I N C I A L A N D T E R R I T O R I A L
G O V E R N M E N T E X P E N D I T U R E B Y
S E X ( 2 0 0 0 )
A G E
A N D
One of the first achievements of the NHEX Roadmap project was the development of
estimates of provincial & territorial government health expenditure by population age and
sex. These estimates were first published in National Health Expenditure Trends,1975 to
2000 edition. Estimates by age and sex are now updated annually and incorporated in the
NHEX Trends publication.
31
The Feasibility Studies are available at http://ottprd01:7778/cihiweb/dispPage.jsp?cw_page=spend_nhexenhance_e
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NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
STUDIES
T H E I M P A C T O F R E G I O N A L I Z A T I O N
O N N A T I O N A L H E A L T H E X P E N D I T U R E S
( J U N E 2 0 0 0 )
This study was carried out to determine the effects of regionalization on health expenditure
estimates and data sources. A second objective was to assess the desirability and the
prospects of reporting health expenditures by regional health boards or within health
regions.
All provinces and territories except Ontario and Yukon have regional boards. Most regional
boards have responsibility for hospitals within their health regions and community-based
substitutes for hospital care. There is considerable diversity among provinces in the extent
of regional responsibility for programs such as public health, mental health and long term
care. Provincial insurance programs for physicians’ services, other providers and
prescription drugs are not regionalized in any province or territory.
Provincial governments are the main source of funds for regional boards. Funding methods
include historical global budgets in most jurisdictions and population-based funding in two
provinces. Regional boards do not raise revenue through taxation or premiums.
# Conclusions and Recommendations
A separate regional sub-sector of finance in NHEX is neither feasible nor advisable at this
time. Expenditures by regional boards are included in provincial/territorial data estimates.
Consequently, the comprehensiveness of health expenditure data in NHEX has not been
adversely affected by the devolution of responsibility for health expenditures to regional
boards. Provincial & territorial public accounts remain the most reliable source of
information about provincial sector expenditures and most public accounts do not break
out health region expenditure.
The development of comprehensive health expenditure estimates within health regions is
not feasible within the limits imposed by present sources of data and data collection
systems. There are no systematic breakdowns of health spending by region of residence
for most provincial programs, other public sectors or the private sector. In order to collect
data by region of residence revised reporting protocols would be required as well as more
detailed, or specially designed, surveys of household expenditure. The resources required
to collect and maintain expenditure data at the regional level would be considerable and
the effort would require a commitment by many stakeholders.
The study recognized the importance of health expenditure data to regional boards and to
studies of regionalization. Given the diversity of responsibilities within existing regional
boards and the differences in programs administered, regional expenditure data will be most
useful when collected for specific health programs and within a consistent framework of
definitions. This approach is being implemented through CIHI’s Guidelines for Management
Information Systems in Canadian Health Service Organizations (MIS Guidelines).
The report recommended that CIHI monitor regional financial responsibilities and sources of
data and re-evaluate recommendations for reporting regional expenditures in NHEX
as appropriate.
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NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
H O M E C A R E E S T I M A T E S
H E A L T H E X P E N D I T U R E S
STUDIES
I N N A T I O N A L
( J U L Y 2 0 0 1 )
This study reviewed the evolution of home care in Canada and assessed the possibility of
expanding the NHEX estimates of home care to include home support as well home health
care, which is reported at present. Home health care is defined as services provided in the
home by home health care professionals (e.g. nurses, physiotherapists). Home support
includes homemaker services, assistance with daily living, and minor home maintenance.
Revised estimates of provincial home care expenditures were developed, incorporating
home support as well as home health care. These estimates showed that home support
has accounted for most of the growth in home care expenditures during the last six years.
Provincial expenditures in fiscal 1998/99 were broken down into home support (48%),
home health care (40%) and an unclassified component (12%) that could not be identified
as either home support or home health care due to insufficient detail.
# Conclusions and Recommendations
The report recommended expanding public sector home care estimates to include all
expenditures by publicly funded home care programs. The estimates should be broken
down into two distinct series of estimates to include both home health care and home
support. It is feasible in most provinces and territories to report separate spending
estimates for both home health and home support. Challenges still exist in certain
jurisdictions, some of which result from reporting protocols that have changed recently.
Separate estimates of home health care and home support are not available in British
Columbia, Alberta, Newfoundland and the Northwest Territories. In certain other provinces
home care information systems are underdeveloped.
The following steps were recommended to deal with problems in separating home health
and home support expenditure data. Pending resolution of data problems, CIHI is presently
collecting data on home support where available but has not expanded the published home
care series to include home support.
•
CIHI should actively lobby federal and provincial government organizations that provide
home care services to develop improved and standardized financial information.
•
Based on these efforts CIHI should develop comprehensive separate series for home
health care and home support as data sources permit.
Private sector estimates of home care expenditure should be defined as:
•
Client cost sharing and co-payments for services provided by public sector
home care programs;
•
Fees paid to private sector home care providers; and
•
Funds raised in the community by home care programs and non-profit
home care providers.
A timetable for production of private sector home care expenditure estimates in
conjunction with data suppliers is being developed.
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NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
L O N G T E R M R E S I D E N T I A L
( J U N E 2 0 0 2 )
STUDIES
C A R E
Long term care in the NHEX database consists of home care and long term residential care.
Long term residential care estimates consist of the category, other institutions. The home
care and long term residential care feasibility studies provided a thorough review of long
term care estimates in both community and institutional settings.
The objectives of the long term residential care study were to clarify definitions, examine
sources of information and recommend revisions to other institutions expenditure estimates
where appropriate. A modified definition for other institutions expenditure developed during
the study is:
Other Institutions include residential health care in long term care
institutions (such as nursing homes), which are normally licensed, approved
or funded by provincial or territorial departments of health and/or social
services. Residential health care in this definition normally involves care by
recognized health professionals, such as nursing staff, employed or
contracted by the institution. Services or facilities solely of a domiciliary or
custodial nature are excluded.
Residential health care is equivalent to care at Type II or higher levels as defined in
Statistics Canada’s Survey of Residential Care Facilities. Data from the Statistics Canada
survey show that approximately 86% of expenditure in licensed facilities is for Type II or
higher levels of care and that institutions for care of the aged account for over 90% of
long term residential care expenditure.
# Conclusions and Recommendations
The study confirmed that public accounts should continue to be used as the source of
information for public sector expenditure. Private sector expenditure will be estimated from
the Survey of Residential Care Facilities, using the Type II threshold to distinguish
residential health care. Historical estimates of private sector expenditure will be revised to
the extent possible.
The study recognized that a significant amount of long term residential care is being
provided in hospitals and classified as hospital expenditure in NHEX. Privately operated
unlicensed residential care facilities reportedly are assuming a larger role in caring for ill
persons, especially the elderly. Issues of care in unlicensed institutions and functional
classification of care in hospitals should be monitored. Expenditure estimates could be
enhanced in future if it becomes possible to recognize these dimensions of long term
residential care.
88
NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
P U B L I C H E A L T H A N D
C O S T S ( J U N E 2 0 0 2 )
STUDIES
A D M I N I S T R A T I V E
This study examined the public health and administrative costs category of NHEX to
determine if it was feasible to create two separate categories. The study recognized that
public health activities and administrative costs of managing health systems were both
topical issues that warranted separate categories in national health expenditure reports.
The study included a thorough review of provincial and territorial data from public accounts
back to 1989/1990 and a targeted review of federal, municipal and workers compensation
data for 1999/2000. Inconsistency or lack of detail in public accounts was a major cause
of variation in the provincial expenditure estimates. A number of specific data reporting
problems were identified.
# Conclusions and Recommendations
The main outcomes of the study were: 1) a new classification system and set of
definitions for public health and administration, and 2) a recommendation to
revise historical estimates in order to separate public health from government
administrative expenditures.
A decision was taken to include program administrative costs with estimates for the
program itself in NHEX (e.g. the administrative costs of operating a home care program).
This decision has been implemented in NHEX Trends 2002. Additional data development
efforts were recommended in order to (i) achieve a consistent classification of community
based mental health and other community based services across the provinces and (ii) to
resolve ambiguities noted in the review of provincial accounts. This work, and the
recommendation to separate public health and administration, will be completed during the
2003 production cycle.
Revised definitions:
•
Public health. Services meant to improve population health, such as health promotion,
disease prevention and health inspection services. In NHEX, public health also includes
mental health, addiction, nursing and miscellaneous services provided in the community
(but not home care).
•
Government administrative costs. Administrative costs of a government department or
branch responsible for health programs, or general administrative services such as
health information systems.
•
Prepayment administration. In the public sector, costs of a provincial government unit
responsible for administration and payment of services insured under the Canada Health
Act. At present, prepayment administration is limited to hospitals and physicians’
services. In the private sector, it is the difference between premiums collected and
claims payments.
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NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
STUDIES
P R I C E I N D E X E S U S E D I N N A T I O N A L
H E A L T H E X P E N D I T U R E S ( A U G U S T 2 0 0 1 )
This study reviewed the price indexes used in NHEX to calculate expenditures at constant
price levels. These indexes are the GDP implicit price index for government current
expenditure on goods and services in the public sector and the health component of the
Consumer Price Index in the private sector. The study included a review of the
performance of these indexes relative to other indexes used in national income and
expenditure accounting, a review of price indexes used by other countries and by the
Organization for Economic Cooperation and Development (OECD).
# Conclusions and Recommendations
The review determined that separate public and private sector price indexes are important
to the definition of growth trends in the two sectors of finance. Alternative indexes that
are available for aggregate expenditures were not expected to provide significant
improvements to the accuracy of indexes being used at present. The indexes are
maintained by Statistics Canada and are available at provincial and territorial levels, both
important considerations for the NHEX estimates.
The aggregate public and private sector indexes are not suitable to deflate specific
categories of expenditure in NHEX. The review determined that a physician price index,
which has been developed by CIHI, would be the most appropriate index for physicians’
services expenditure. There is considerable potential to develop a hospital price index using
Case Mix Groups weighted by Resource Intensity Weights in the Discharge Abstract
Database and costs in the Canadian MIS Database (all CIHI products). A second feasibility
study was undertaken to develop the hospital index and it is underway at present with a
target completion date in 2003.
The prospects for developing price indexes for other categories were uncertain.
Recommendations suggested approaches that can be developed further in the future as
resources permit. In the case of drug prices, it was recommended that CIHI follow relevant
activities by academic groups and regulatory agencies. If possible, CIHI should attempt to
facilitate the development of a new drug price index that would be more acceptable to
analysts than current methodologies.
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NATIONAL HEALTH EXPENDITURE TRENDS F E A S I B I L I T Y
STUDIES
R E C O N C I L I A T I O N O F N H E X W I T H
F I N A N C I A L M A N A G E M E N T S T A T I S T I C S
( S T A T I S T I C S C A N A D A )
This project was a joint study by CIHI and the Public Institutions Division of Statistics
Canada to reconcile NHEX public sector expenditure estimates with the health spending
statistics produced by the Financial Management System (FMS) at Statistics Canada.
The FMS compiles data on expenditure by all levels of government and classifies them
within 17 functional categories, one of which is health. A function is defined as ‘the
principal purpose for which an expenditure is made rather than the activity involved.’
Certain expenditures that are considered health activities in NHEX are classified under
other functional categories in FMS, for example expenditures by hospitals operated by the
Department of National Defence and the Department of Veterans Affairs.
The study found that conceptual approaches accounted for most of the differences
between health expenditure estimates in NHEX and FMS. One major difference was the
allocation of private sector income in public hospitals to the private sector in NHEX and to
government estimates in FMS (FMS includes all expenditures by a public sector
institutional unit as public sector expenditure). A number of unexplained differences
remained after the detailed reconciliation. Different treatment of health expenditure by
provincial departments of Social Services was considered to be an important factor in
accounting for unresolved differences.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Methodological Notes
C O N C E P T S
A N D
D E F I N I T I O N S
Mandate of the National Health Expenditure Database (NHEX)
The mandate of the National Health Expenditure (NHEX) database is twofold:
1. To support the development and evaluation of health programs in Canada by all levels
of government, and within the private sector.
2. To compile information on health expenditures that will accurately portray the
importance of health care as a component of national expenditure.
# Variables and Concepts
Health Expenditure—includes any type of expenditure for which the primary objective is to
improve or prevent the deterioration of health status.
This definition allows economic activities to be measured according to primary purpose and
secondary effects. Activities that are undertaken with the direct purpose of improving or
maintaining health are included. Other activities are not included, even though they may
impact health. For example, housing and income support policies have social welfare goals
as their primary purpose and are not considered to be health expenditures, yet they are
recognized as powerful factors in determining population health.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Figure 63—Composition of Total Health Expenditures, by Source of Finance
Provincial Government Sector
PUBLIC SECTOR
Federal Direct Sector
Other Public Sector
TOTAL
Health
Expenditures
Muncipal Government Sector
Social Security
Funds
Non-Consumption
PRIVATE SECTOR
Workers'
Compensation Boards
Quebec, Drug
Insurance Fund
Out-of-Pocket
Commercial Insurance Firms
Private Health Insurance
Not-for-Profit Insurance Firms
# Source of Finance (Sectors)
National health expenditures are reported based on the principle of responsibility for
payment rather than on the source of the funds. It is for this reason, for example, that
federal health transfers to the provinces are included in the provincial government sector
since it is the responsibility of provincial governments to expend federal transfers on health
services. The exception to this principle is that provincial government health transfers to
municipal governments are included in the provincial government sector.
Public Sector—includes health care spending by governments and government agencies. It
is sub-divided into four levels, as described below:
1. The Provincial Government Sector includes health spending from provincial/territorial
government funds, federal health transfers to the provinces/territories, and provincial
government health transfers to municipal governments.
2. The Federal Direct Sector refers to direct health care spending by the federal
government in relation to health care services for special groups such as Aboriginals,
the Armed Forces and veterans, as well as expenditures for health research, health
promotion and health protection. Federal Direct health expenditure does not include
federal health transfers to the provinces.
3. The Municipal Government Sector expenditure includes health care spending by
municipal governments for institutional services; public health; capital construction and
equipment; and, dental services provided by municipalities in the provinces of Nova
Scotia, Manitoba and British Columbia. Designated funds transferred by provincial
governments for health purposes are not included in the municipal sector, but are
included with provincial government expenditure.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
4. Social Security Funds are social insurance programs that are imposed and controlled by
a government authority. They generally involve compulsory contributions by employees,
employers or both, and the government authority determines the terms on which
benefits are paid to recipients. Social security funds are distinguished from other social
insurance programs, the terms of which are determined by mutual agreement between
individual employers and their employees. In Canada, social security funds include the
health care spending by workers' compensation boards and the drug insurance fund
component of the Quebec Ministry of Health and Social Services drug subsidy program.
Health spending by Workers' Compensation Boards (WCB) includes what the provincial
boards commonly refer to as medical aid. Non-health related items often reported by
the Workers’ Compensation Boards as medical aid expenditure such as funeral
expenses, travel, clothing etc. are removed.
On January 1, 1997 the government of Quebec introduced a drug program that covered
residents of the province, who were not otherwise covered by the provincial program or
by private health insurance generally offered through employment. Drug claims for these
participants of the new plan are paid from the Drug Insurance Fund. This component of
the Quebec drug program is self-funded (i.e. it is funded through the compulsory
payment of premiums and not by the provincial government of Quebec).
Private Sector—includes out-of-pocket expenditures made by individuals for health care
goods and services; the health insurance claims paid by commercial and not-for-profit
insurance firms, as well as the cost of administering those claims; non-patient revenues
received by health care institutions such as donations and investment income; private
spending on health-related capital construction and equipment; and, health research funded
by private sources.
# Use of Funds (Categories)
Hospitals—are institutions where patients are accommodated on the basis of medical need
and are provided with continuing medical care and supporting diagnostic and therapeutic
services. Hospitals are licensed or approved as hospitals by a provincial/territorial
government, or are operated by the Government of Canada and include those providing
acute care, extended and chronic care, rehabilitation and convalescent care, psychiatric
care, as well as nursing stations or outpost hospitals.
Other Institutions—include residential care types of facilities (for the chronically ill or
disabled, who reside at the institution more or less permanently) and which are approved,
funded or licensed by provincial or territorial departments of health and/or social services.
Residential care facilities include homes for the aged (including nursing homes), facilities
for persons with physical disabilities, developmental delays, psychiatric disabilities, alcohol
and drug problems, and facilities for emotionally disturbed children. Facilities solely of a
custodial or domiciliary nature and facilities for transients or delinquents are excluded.
95
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Physicians—expenditures include primarily professional fees paid by provincial/territorial
medical care insurance plans to physicians in private practice. Fees for services rendered in
hospitals are included when paid directly to physicians by the plans. Also included are
other forms of professional incomes (salaries, sessional, capitation).
The physician expenditure category does not include the remuneration of physicians on the
payrolls of hospitals or public sector health agencies; these are included in the appropriate
category, e.g. hospitals or other health spending.
Other Professionals—services, at the aggregate level represent expenditures for the
services of privately practicing dentists, denturists, chiropractors, massage therapists,
orthoptists, osteopaths, physiotherapists, podiatrists, psychologists, private duty nurses,
and naturopaths. Discrete identification of many of the professions included under other
professional services is often possible only when they are reported by provincial medical
care insurance plans.
This category has been disaggregated at the Canada level in the Data Tables to provide
information on the following sub-categories:
Dental Services—expenditures for professional fees of dentists (includes dental
assistants and hygienists) and denturists, as well as the cost of dental prostheses,
including false teeth and laboratory charges for crowns and other dental appliances.
Vision Care Services—expenditures for the professional services of optometrists and
dispensing opticians, as well as expenditures for eyeglasses and contact lenses.
Other—expenditures for chiropractors, massage therapists, orthoptists, osteopaths,
physiotherapists, podiatrists, psychologists, private duty nurses, and naturopaths.
Drugs—at the aggregate level, include expenditures on prescribed drugs and non-prescribed
products purchased in retail stores. This category has been disaggregated at the Canada
level in the Data Tables to provide information on the following sub-categories:
Prescribed Drugs—substances sold under the Food and Drug Act which require a
prescription.
Non-prescribed Drugs—include two sub-components; Over-the-Counter drugs; and,
Personal Health Supplies.
Over-the-Counter Drugs—therapeutic drug products not requiring a prescription.
Personal Health Supplies—include items used primarily to promote or maintain health,
e.g. oral hygiene products, diagnostic items such as diabetic test strips and medical
items such as incontinence products.
The drug category does not include drugs dispensed in hospitals and generally in other
institutions. These are included with the category of hospitals or other institutions.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Capital—includes expenditures on construction, machinery and equipment of hospitals,
clinics, first-aid stations, and residential care facilities. (See also Methodological Notes.)
Public Health and Administration—expenditures for items such as measures to prevent the
spread of communicable disease, food and drug safety, health inspections, health
promotion activities, community mental health programs, public health nursing and all
costs for the infrastructure to operate health departments.
Other Health Spending—at the aggregate level includes expenditures on home care,
medical transportation (ambulances), hearing aids, other appliances and prostheses,
prepayment administration, health research and miscellaneous health care. This category
has been disaggregated at the Canada level in the Data Tables to provide information on
the following sub-categories:
Prepayment Administration—expenditures related to the cost of providing health
insurance programs by either government or private health insurance firms.
Health Research—expenditures for research activities designed to further knowledge
of the determinants of health, health status or methods of providing health care,
evaluation of health care delivery or of public health programs. The category does not
include research carried out by hospitals or drug companies in the course of product
development. These amounts would be included with the hospital or drug categories
respectively.
Other—expenditures for items such as home care, medical transportation
(ambulances), hearing aids, other appliances, training of health workers, voluntary
health associations, and occupational health to promote and enhance health and
safety at the workplace.
The definition of home care that is currently in use in the National Health Expenditure
Database is based on the definition used by the OECD, under which only the health
professional component of home care is intended to be included. The portion that is
commonly referred to as home support is considered to be a social service expenditure
rather than a health expenditure and is excluded when it can be identified. A Home
Care Feasibility Study at CIHI investigated the feasibility of developing a set of
estimates that identify both the health professional and the home support components
of home care. The process of updating the data collected in this study is underway in
order to assess the feasibility of reporting this set of estimates.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
# Other Terms
Federal Transfers—refer to the total of the various federal-provincial-territorial health
financing arrangements, which include at various times the Canada Health and Social
Transfer (CHST); the Canada Assistance Plan (CAP); Established Programs Financing (EPF);
the Health Resource Fund which supported provincial capital health expenditures from the
mid 1970s to the early 1980s; and, transfers by the Department of Indian and Northern
Affairs to the territorial governments for the medical care and hospital insurance plans on
behalf of Aboriginal peoples.
Canada Health and Social Transfer (CHST)—on April 1, 1996 the CHST replaced
federal transfers for social assistance under the Canada Assistance Plan (CAP), and
for health and post secondary education under Established Program Financing (EPF).
The CHST is a block fund provided in the form of both cash transfers and tax point
transfers to all provinces/territories in support of health, post-secondary education,
social assistance and social service programs. Provinces may allocate the CHST to
health and other social programs according to their particular priorities while
upholding the criteria and conditions of the Canada Health Act. In 1996/1997 CHST
transfers were allocated among the provinces and territories in the same proportions
as provincial entitlements under the combined EPF and CAP transfers
in 1995/1996.32
Canada Assistance Plan (CAP)—introduced in 1966 by the federal government to
share in eligible costs incurred by the provinces and territories in providing social
assistance and welfare services to persons in need or persons likely to become in
need if these services were not provided. The 1994 budget limited 1995/1996 CAP
transfers for all provinces/territories at 1994/1995 levels.33
Established Programs Financing (EPF)—prior to the introduction of the CHST the
federal government contributed to the operation of provincial/territorial health
insurance plans according to the provisions of the Federal-Provincial Fiscal
Arrangements and Federal Post-Secondary Education and Health Contributions Act,
1977 (EPF Act). Under the Act, provinces and territories were entitled to equal per
capita federal health contribution increases according to a fixed formula (escalator).
Health contributions to the provinces consisted of both cash and an equalized tax
transfer. The February 26, 1991 federal budget extended a freeze at 1989/1990
levels to 1994/1995. Legislation later provided for EPF entitlements to grow in
1995/1996 in accordance with the escalator, less three percentage points.
32
33
Health Canada, Canada Health Act Annual Report, 2000–2001, 2001, p. 315.
Human Resources Development Canada, Cost Shared Programs, Provincial Entitlements under the Canada Assistance Plan,
February, 1996, (unpublished).
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Gross Domestic Product (GDP)34—is the unduplicated value of production originating within
the boundaries of Canada, regardless of the ownership of the factors of production. Gross
Domestic Product can be valued either at factor cost or at market prices. In this publication
GDP is valued at market prices and is expressed in terms of the prices actually paid by the
purchaser. It includes all indirect taxes, such as sales and excise taxes, customs duties and
property taxes and also reflects the impact of subsidy payments.
Implicit Price Indices—see Methodological notes, Calculation of Constant Dollars.
Purchasing Power Parity (PPP)35—Purchasing Power Parities (PPPs) are the rates of
currency conversion that equalize the purchasing power of different currencies. This means
that a given sum of money, when converted into different currencies at the
PPPs rates, will buy the same basket of goods and services in all countries. Thus PPPs
are the rates of currency conversion, which eliminate differences in price levels
between countries.
M A J O R
D A T A
L I M I T A T I O N S
Data contained in the national health expenditure database are estimates. The data are
collected from diverse sources and include varying classes of financial information. The
data are collected and classified according to methods established by a Review Committee.
CIHI analysts and external experts continue to improve the comprehensiveness, accuracy
and currency of the data, in order to provide the most complete and objective estimates
possible. A series of feasibility studies were conducted to determine the advisability and
possibility of expanding estimates in the NHEX database for a number of priority issues.
For a summary of these studies please refer to the section on NHEX Roadmap Feasibility
Studies. Notwithstanding, national health expenditure data are estimates and should be
used accordingly.
Most private sector expenditures are estimated from survey data. Prior to 1996, the Family
Expenditure Survey by Statistics Canada36, an important source of private sector data, was
not carried out annually; therefore, trend data have been imputed for years between
surveys. Private sector data were revised following a methodology review in the early
1990s. The revised private sector data incorporated information estimated directly from
new sources for 1988 and subsequent years. Prior years were estimated using trend data.
As a result, readers should use caution when using the private sector expenditure data for
small provinces and for years prior to 1988.
34
35
36
Statistics Canada, Guide to the Income and Expenditure Accounts, catalogue 13-603E, 1996, pp. 137 and 139.
OECD Health Data 2002, Organisation for Economic Cooperation and Development, Paris, 2002.
Family Expenditure in Canada, Statistics Canada Catalogue Number 65-555. Statistics Canada, Periodical, Ottawa.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
C O L L E C T I O N
A N D
NOTES
N O N - R E S P O N S E
The following notes briefly describe some of the major technical points associated with the
compilation of the health expenditure estimates. Additional information can be obtained by
contacting the National Health Expenditure section by phone (613) 241-7860, by fax (613)
241-8120, or by e-mail [email protected]
# Hierarchy of Classification
National health expenditures in Canada are based on a system of classification that is
consistent with international standards developed by the Organisation for Economic
Co-operation and Development (OECD) for reporting of health expenditures.37
National health expenditures are grouped within the broad categories of Personal Health
Care or Other Expenditures:
Personal health care consists of expenditure for health goods and services used
by individuals.
Other health expenses consist of expenditures on behalf of society, such as public
health; expenditures made as investments for purposes of future consumption, such as
capital expenditures; the administrative expenses of planning and managing the health
care system; and research.
Personal health expenditures are classified within categories that describe the type of
health care used. Certain categories overlap. The hierarchy of classification that is used to
allocate overlapping categories of expenditure is:
Institutional setting—health care services consumed in hospitals or other institutions are
allocated to the institutional category if the institution purchases the services on behalf
of its patients. For example, physicians services and drugs paid through hospital
budgets are classified as hospital expenditures. This allocates expenditure to the
supplier actually paid by patients or their agents in the form of government or insurance
companies. It also reflects data availability.
Self employed provider of service—for example, all expenses of physicians’ practices
are considered to be expenditures for physicians services, even though some of these
expenses would be for employment of other health professionals, drugs or personal
health supplies.
Type of good and service—drugs, personal health supplies and appliances
are examples.
37
Statistics Canada (Public Institutions Division) publishes estimates of government health expenditure as part of its
comprehensive reporting system of all government expenditures, the Financial Management System (FMS). The FMS
public sector health spending estimates are lower than those reported by CIHI because different classification methods are
applied and a narrower definition of health expenditure is used in the FMS.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
An exception to the hierarchy of classification is eye care, in which optometrists
services, eyeglasses and contact lenses sold by optometrists and eyeglasses sold by
opticians are combined as one category, vision care services.
The definitions and methods used in the preparation of this document are for the most part
based on those adopted in 1994 by the National Health Expenditure Methodology Review
Committee. This committee included representation from Health Canada, Statistics
Canada, Ministère de la santé et des services sociaux du Québec, the Canadian Medical
Association and the Canadian Healthcare Association. Some of the recommendations for
change made during that process are still under development.
# General Methods
The following is intended as a general overview of the methods applied to calculate
estimates of health expenditure in Canada. More detailed information can be obtained by
contacting the National Health Expenditure section by phone (613) 241-7860, by fax (613)
241-8120, or by e-mail [email protected]
Provincial Government
Data are extracted annually from provincial/territorial government Public Accounts.
Programs and/or program items are classified into health expenditure categories according
to accepted and standardized methods and definitions used in estimating national health
expenditure. Data from the Public Accounts are supplemented with information from
provincial/territorial Government Department Annual Reports and Annual Statistical Reports
when available, as well as, information provided by provincial/territorial government
department officials. Total provincial government health spending figures include spending
for health services reported by the provincial/territorial ministry responsible for health as
well as by other departments that report spending on health according to National Health
Accounts definitions.
Adjustments for regional health authority and/or hospital deficits or surpluses are not made
in the National Health Expenditure Database unless the provincial government assumes
them. Once assumed by the provincial government they are allocated to the years when
the regional health authority and/or hospitals accumulated them.
CIHI's 2000/2001 estimates of provincial government health expenditure were submitted
to provincial/territorial departments of health for review.
Provincial government figures identified as forecasts are based on the growth rates of
major programs reported in provincial/territorial government Main Estimates and Budgets.
On April 1, 1999 Nunavut was formed from the eastern part of the Northwest Territories.
N.W.T. expenditures for calendar year 1999 include expenditures for Nunavut for one
quarter of the year ending March 31, 1999, prior to the formation of Nunavut.
Consequently, expenditure data for N.W.T. for calendar year 1999 are not comparable to
data for calendar years prior to 1999 or to 2000.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Private Sector
Private sector data were revised in 1995 following a methodology review that began in the
early 1990s. Private sector data under the revised methodology incorporated information
estimated directly from new sources for 1988 and subsequent years. Expenditure amounts
prior to 1988 were estimated using trend data. Therefore, readers should exercise caution
when using the private sector expenditure data for small provinces and for years prior to
1988.
Health Insurance claims by category and premiums are collected from nine not-for-profit
insurance companies and the Canadian Life and Health Insurance Association, which
survey their member companies. The difference between claims and premiums is allocated
to the category of prepayment administration, which relates to the cost of providing health
insurance programs. Currently, health care spending data by insurance companies
providing casualty insurance is not included in the estimates.
Out-of-Pocket health expenditures are based on purchased data from the Survey of
Household Spending (SHS), formerly the Family Expenditure Survey, fielded by Statistics
Canada. Only category data from section "P" of the survey on Direct Costs for Health Care
are used; the SHS categories of "Other Medicines, Drugs and Pharmaceuticals"
(i.e. not prescribed by a doctor) and, "Hospital Care" are replaced with data from other
sources as described below. National health expenditure estimates are equal to the average
expenditure per household for each category multiplied by the estimated number of
households.
The SHS is an annual survey, which began in 1996. Prior to 1996, full surveys that
included both urban and rural areas were carried out in 1986 and 1992. In 1990 a survey
was conducted that included only metropolitan areas. In years when complete surveys are
carried out, data are available for the ten provinces and for 17 urban centres. The urban
centres include Yellowknife and Whitehorse, which are used to derive estimates of
expenditure in the territories. Metropolitan expenditures per household tend to be
somewhat higher than provincial estimates. All relevant categories were updated in
complete survey years. In years when only urban surveys were carried out, the percentage
changes in urban expenditures within each province or territory were used to update
category estimates from complete survey years.
Between 1992 and 1996 when no surveys were conducted, provincial growth rates of the
Statistics Canada variables of personal expenditure on medical care and dental care; drug
and drug sundries; and, other health care, were used to impute missing years.
The SHS category of "Other Medicines, Drugs and Pharmaceuticals" i.e. not prescribed by
a doctor, is replaced with information purchased from the research company A.C. Nielsen
which tracks consumer sales of non-prescribed drugs sold in Canada at retail. Each year,
A.C. Nielsen reports retail sales data for two consistent years for 48 plus non-prescribed
drug categories. Data are reported by sales channel,38 total dollar sales volume; and, by
regional sales distribution for five regions that includes nine provinces. Newfoundland and
38
As a general rule Statistics Canada definitions govern the classification of stores by class of trade. Sales channels include
Drug Stores; Food Stores with Pharmacies; Grocery Banners; Mass Merchandiser and Warehouse Clubs, which are
estimated from A.C. Nielsen's household panel data.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
the territories are not included. The data is processed by classifying the non-prescribed
drug categories as either over-the-counter drugs or personal health supplies. Regional
sales amounts are separated into nine provinces and estimates for Newfoundland and
the territories are calculated, using provincial distributions of Direct Costs for Health Care
from the SHS. Lastly, appropriate provincial and federal sales taxes are incorporated into
the estimates.
The SHS category of Hospital Care is not used; instead the out-of-pocket component of
hospital care is calculated based on income from patient services from Statistics Canada's
Annual Return of Health Care Facilities (HS-2) and CIHI's Canadian MIS Database (CMDB),
less hospital care from insurance sources.
Private sector estimates of other institutions are derived from data from Statistics Canada's
Residential Care Facilities Survey (RCF). Data used from the survey include income to
facilities from co-insurance or self-pay of residents; differential for preferred
accommodation; and, sundry earnings. The last year that data was publicly available was
from the 1993/1994 survey. Data in this report is based on preliminary figures provided in
the 1994/1995 survey. Data used in previous reports for 1996/1997 to 1998/1999 has
been revised with updated data from those survey years. In addition, data from the
1999/2000 survey has also been included. Data that is missing from the survey are
imputed based on estimates by Statistics Canada and or CIHI.
The Non-Consumption component of the private sector includes non-patient revenue to
hospitals including ancillary operations, donations, investment income etc. This data is
derived from Statistics Canada's and CIHI's Hospital Surveys.
The non-consumption portion of the private sector also includes expenditures for
biomedical and health care research by Canadian faculties of medicine derived from
Medical Education Statistics published by the Association of Canadian Medical Colleges.
Included are amounts for research funded by national and provincial not-for-profit
foundations such as the Heart and Stroke Foundation of Canada, the National Cancer
Institute of Canada, the Canadian Cancer Society, to name only a few. In addition, funding
from local sources, internal university sources, university and unaffiliated hospitals, and
foreign sources are also included. The sum of these amounts is provincially distributed
according to the reported distribution of total amounts spent on research by the various
faculties of medicine across the country.
Capital expenditure in the private sector is also included as a non-consumption component
category. Additional information on the calculation of capital can be found in the
Methodological notes in the Calculation Methods section under Capital Expenditure and in
the Forecasting Method section.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Federal Direct
Data on Federal Direct health care spending is derived from information provided by federal
government organizations supplemented with information from the National
Public Accounts. Federal government health care spending is generally provided
according to the province in which the expenditure was made. Some data, however,
is provided only at the national level, in these cases it is distributed by the appropriate
provincial/ territorial population.
Municipal Government
Municipal Government health care spending is based on information provided by the Public
Institutions Division of Statistics Canada. This data is supplemented with an estimate of
spending by municipal governments on other institutions, which is based on information
from Statistics Canada's Residential Care Facilities Survey.
Social Security Funds
In Canada, social security funds include the health care spending by workers'
compensation boards and the drug insurance fund component of the Quebec Ministry
of Health and Social Services drug subsidy program. The Workers’ Compensation Board
data are derived from special tabulations from each provincial and territorial Workers'
Compensation Board of their medical aid expenditures. Income replacement and
occupational rehabilitation is not included. Items included as medical aid that do not
meet the National Health Expenditure definition of health expenditures such as funeral
expenses, clothing expenses, hotel accommodation, and non-medical transportation
are excluded.
The Workers' Compensation Boards data is supplemented in Quebec after 1996 with the
portion of the Régie de l'assurance maladie du Québec's drug program that is not funded
by the ministry of health and social services. See the definition of Social Security Funds in
the Concepts and Definitions section of this report for additional information.
# Calculation Methods
Calculation of Average Annual Rate of Growth
The Average Annual Rate of Growth is the constant annual rate necessary for a value at
the beginning of a period to grow to a value at the end of a period over the number of
compounding years in the period. The formula used to calculate the average annual rate of
growth is:
=e
(ln(value at end of period) - ln(value at beginning of period))/T
Where the constant e equals 2.718, which is the base of the natural logarithm, and T
equals the number of years in the period.
Calculation of Calendar Year
Some information sources provide data in fiscal years. Calendar year data were derived by
adding ¾ of one fiscal year to ¼ of the previous fiscal year.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Calculation of Constant Dollars
Real health expenditure and real per capita health expenditure are presented in constant
1997 dollars. Constant dollar expenditure was calculated using price indices for public and
private expenditures in each province and territory. The indices are the implicit price indices
(IPI) for government current expenditure, which are used to deflate public sector health
care spending, and the health component of the Consumer Price Index (CPI), which are
used to deflate private sector health care spending. Statistics Canada developed both sets
of indices. A more complete explanation of the methodology for calculating implicit price
indices is available in Statistics Canada publications.39
In the health expenditure series, public and private expenditures are adjusted separately in
each province using the appropriate index. Adjusted values are summed to obtain Canada
totals at constant dollar values. Consequently, the overall implicit price index of the health
expenditure series reflects the mix of public and private expenditures reported in the
National Health Expenditure database.
The government current expenditure index was forecast for 2002 for the provinces and
territories. The forecasts are based on the Conference Board of Canada's forecasts of this
index for Canada, Ontario and Quebec and CIHI's forecasts for the remaining provinces.
The CPI (health) index was forecast to December 2002 based on the average of the
monthly index up to September 2002, which was the latest information available prior to
the publication of this report.
Calculation of TOTAL Health Expenditure as a Percent of Gross Domestic Product
The Gross Domestic Product at market prices40 was used to express total health
expenditure as a percentage of GDP. National GDP figures for Canada were used rather
than the sum of provincial/territorial GDP to calculate the total health expenditure to GDP
ratio for Canada.
Gross Domestic Product (GDP) figures provided by Statistics Canada were revised
(upward) in 2001 as part of their overall revision to the methods for measuring the nation's
economic activity. Revised GDP figures for Canada were available from 1975 to 2000.
Revised provincial and territorial GDP figures were available from Statistics Canada from
1981 to 1999. No attempt was made by CIHI to estimate provincial GDP prior to 1981.
Forecasts of Gross Domestic Product figures at both the national and provincial/territorial
levels for 2002 were prepared by CIHI by applying the Conference Board of Canada’s
latest 2002 forecasted growth rate of GDP to the 2001 GDP figures from Statistics
Canada.
39
40
For example, Guide to the Income and Expenditure Accounts, Statistics Canada catalogue number 13-603E, Statistics
Canada, Ottawa.
Source: National Accounts and Environment Division, Statistics Canada
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Calculation of Per Capita Dollars
Per capita health expenditures were calculated using the most recent revised population
estimates from the Demography Division of Statistics Canada. This takes into account the
results of the census adjustment for net census under-count, non-permanent residents and
returning Canadians. Population figures for 2002 are projections from the Demography
Division of Statistics Canada.
Calculation of TOTAL Health Expenditure
Total health expenditure refers to the sum of the public and the private sectors. Canada
refers to the sum of the 10 provinces and 3 territories. Total health care spending in
constant 1997 dollars is the sum of public sector health care spending in constant 1997
dollars and private sector health care spending in constant 1997 dollars. Canada Average
is the sum of provincial/territorial expenditures divided by the sum of provincial/territorial
data of another variable, such as population.
Capital Expenditure
Prior to a major methodology review in 1995, several categories in the private sector were
estimated using a residual method, whereby public sector spending was subtracted from
an estimated total. The remainder was allocated entirely to the private sector. Following a
major methodology review in the early 1990s, capital expenditure remained as the only
category that was estimated this way. In 1998, the method of calculating capital
expenditure was reviewed and revised. Capital expenditure for the private sector, provincial
and municipal government sectors, is now estimated from information obtained from the
Investment and Capital Stock Division at Statistics Canada. Capital expenditure in the
federal direct sector is obtained from the national public accounts and federal departments
that provide health services. There are no capital expenditures in the Social Security Funds
sector. The implications of this change are twofold; capital expenditure in all sectors is
based on full cost or cash basis accounting principles; and, capital is the only category of
expenditure in which spending is categorized as private or public based on ownership of
the facility in which the investment is made. This convention has been adopted due to data
limitations.
Forecasting Methods
Provincial government sector health-spending forecasts for 2001 and 2002 are based on
the growth rates of a consistent set of major health programs of provincial health
departments reported in provincial Main Estimates and Budgets. In the case of territorial
government forecasts of the Northwest Territories and Nunavut in 2001 and 2002,
estimates were based on amounts reported in their Main Estimates. In other sectors, 2001
and 2002 figures for these two territories were calculated by developing a forecast for the
Northwest Territories including Nunavut. The share of Nunavut spending in the last year of
actual data (2000) of the combined total of the Northwest Territories and Nunavut was
used as a proxy to break out the forecasts for the Northwest Territories and Nunavut for
2001 and 2002.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
The 2001 figures for capital expenditure in the provincial government sector, the municipal
government sector and the private sector are based on “preliminary actual” figures from
the Investment and Capital Stock Division of Statistics Canada. The 2002 capital figures
are based on “intentions”.
Forecasts for 2001 and 2002 for the remaining categories in the Federal Direct, Workers’
Compensation Boards, Municipal Government and the Private sector were made entirely
based on econometric analysis of time series trends. For each series, up to 40 different
univariate forecasting specifications were evaluated, and the best one (based on the root
mean square error of prediction) was selected. The functional forms studied included the
exponential smoothing family (simple, double, Holt, Brown, Winters, damped trend, etc.);
time trends; ARIMA specifications; etc. Logarithmic transformations were used when the
data warranted its use.
Forecasts of health expenditures are identified in the figures by special symbols and in the
Data Tables by the letter "f".
Gross Domestic Product figures at both the national and provincial/territorial levels for
2002 were forecast by CIHI by applying the Conference Board of Canada’s 2002
forecasted growth rate of GDP to the 2001 GDP figures from Statistics Canada.
The government current expenditure price index was forecast for 2002 for the provinces
and territories. The forecasts are based on the Conference Board of Canada's latest
forecasts of this index for Canada, Ontario and Quebec and CIHI’s forecasts of the
remaining provinces.
The CPI (health) index was forecast to December 2002 based on the average of the
monthly index up to September 2002, which was the latest information available prior to
the publication of this report.
# Age and Sex Distribution Methods
The Series E Data Tables present provincial government health expenditure for selected
categories of spending by sex and eight age groupings. This is the fourth year of a data
development project to age-sex standardize per capita health expenditure by province. This
year CIHI has presented five categories of expenditure for 1996 to 2000 and included an
estimate of total provincial/territorial government expenditure by age, sex, and by
province/territory for 1998, 1999, and 2000. The five categories presented are hospitals,
other institutions, physicians, other professionals and drugs. The method of distributing the
five categories and total is explained below. The data reported in Series E of the Data
Tables are not age-sex standardized.
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NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Hospitals
The distribution of provincial government hospital expenditure by age and sex is based on
information from CIHI's Discharge Abstract Database (DAD) 41 and Hospital Morbidity
Database (HMDB). The CIHI 1999 Case Mix grouping methodology (CMGTM) was used to
group patient discharge information into homogenous groups, based on clinical and
resource utilization characteristics.
In the CMG methodology, patients are assigned to a group according to diagnosis and
surgical procedures. Within each group patients are further classified into a complexity
level42 based on the number and type of co-morbid diagnoses and the age of the patient.
Once the patient is grouped, a Resource Intensity Weight (RIWTM)43 is assigned. The
assigned RIWs were then aggregated to generate total weighted cases by age and sex.
The provincial government hospital expenditure estimate for each province is allocated to a
given age group based on the weighted cases in that age group relative to total weighted
cases. Weighted case information from the DAD and Morbidity Database is for acute
inpatient care only. Weighted cases for the majority of hospital-based ambulatory care (i.e.
day surgery, emergency departments and clinics) are currently only available in one
province. Nevertheless, acute inpatient weighted cases is used as a proxy to distribute the
National Health Expenditure estimate of hospital expenditure financed by provincial
governments, which includes inpatient and ambulatory care.
CIHI investigated the reasonableness of using the acute inpatient data as a proxy to
distribute comprehensive provincial government hospital expenditures by comparing
1998/1999 weighted cases calculated from Alberta's Ambulatory Care data set with the
Alberta acute inpatient weighted cases from the DAD/HMDB. The analysis showed that the
distribution of ambulatory care weighted cases differs from inpatient weighted cases
primarily in the senior age groups. The impact of including the ambulatory care weighted
cases with the inpatient weighted cases is to lower per capita spending in the senior age
groups from what it would have been based on the inpatient weighted cases only.
Data from the DAD/HMDB covers 11 jurisdictions across Canada; the territories are
combined due to the small number of facilities. The Yukon, Northwest Territories and
Nunavut (1999 and 2000) were distributed according to a combined territorial
distribution and further distributed based on population. Data for Prince Edward Island and
Saskatchewan from the DAD for 1995/1996 to 1997/1998 represents about 85% total
acute hospitalizations within each province, however from 1998/1999 onward the DAD
represents 100% coverage in these two provinces. Weighted cases for Quebec are based
entirely on the Hospital Morbidity Database.
41
42
43
The Discharge Abstract Database receives information from participating hospitals that represent about 85% of all hospital
discharges in Canada. The database contains clinical, demographic and administrative data for inpatient acute, chronic and
rehabilitation care and day surgery.
Following extensive consultation with experts in the field, at the time of printing it is believed that these data have not
been substantially effected by recent concerns regarding complexity that relate to more current data.
RIWs are resource allocation algorithms, developed by CIHI for estimating the relative hospital resources used for a typical
case. See http://ottprd01:7778/cihiweb/dispPage.jsp?cw_page=casemix_riw_e for more information.
108
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Caution should be exercised when comparing age and sex expenditure estimates across
provinces, particularly with respect to Manitoba. Manitoba hospital utilization data is
reported to CIHI differently than in other provinces and territories. In addition to acute
inpatient care, Manitoba’s weighted cases include chronic, rehabilitative and long-term
hospital care, which results in higher weights applied to senior age groups, and ultimately
higher spending in those age groups. CIHI is currently investigating methods of removing
the additional cases in Manitoba to produce an age-sex distribution that is consistent with
other provinces. Manitoba weighted cases were generated from the Discharge Abstract
Database which represent approximately 65% of total acute hospital separations in
Manitoba. All provincial/territorial data was provided in fiscal year and converted to
calendar year (see Calculation Methods).
Physicians
The distribution of provincial government physician expenditure by age and sex is based on
information from CIHI's National Physician Database (NPDB). The NPDB contains data on
the socio-demographic and billing activities of fee-for-service physicians, as well as on the
age and sex of patients. NPDB data is used as a proxy to distribute all physicians’ services
expenditure from the National Health Expenditure database (NHEX). NHEX includes
primarily professional fees, paid by provincial medical care insurance plans to physicians in
private practice but also includes alternative payment methods such as salaries, sessional
and capitation payments.
Fiscal year 1996/1997 data was unavailable from the NPDB for Nova Scotia, and was
estimated using growth rates in the population by age and sex applied to the 1995/1996
fee-for-service data from the NPDB. Data for 1995/1996 was also unavailable from NPDB
for New Brunswick. Similar to Nova Scotia, it was estimated using growth rates in the
population by age and sex applied to 1994/1995 fee-for-services data from the NPDB.
Yukon fee-for-service data from 1995/1996 to 1999/2000 was used to estimate the
Northwest Territories by applying the Yukon fee-for-service per capita spending by age and
sex to the Northwest Territories population for 1995/1996 to 1999/2000. Similar to the
Northwest Territories, Nunavut for 1999/2000 and 2000/2001 was estimated using the
Yukon data. Data was collected in fiscal year and converted to calendar year (see
Calculation Methods).
Other Institutions
Statistics Canada’s Residential Care Facilities Survey (RCF) was used to estimate the
provincial/territorial age and sex distribution from 1995/1996 to 2000/2001 for other
institutions. Facilities for Delinquents, Transients and others, were excluded from the
age-sex distribution. Only facilities financed to provide a level of care for type II or higher
were considered for the estimation. These levels of care require a minimum of at least
one and half-hours a day of medical and/or professional nursing supervision. Patient counts
by age and sex and by predominant level of care within each facility was used
to create the distributions.
109
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
In order for a facility’s patient count to be included it was also necessary for the facility to
report both income from provincial/territorial government sources and days of care for
provincial government funded clients. Within a particular facility type, patient counts by
age and sex were weighted based on the predominant level of care. Weights were
generated using the estimated cost per patient for a particular type of care relative to type
II. That is, type II care was the basis and had a weight of one. Once patient counts by age
and sex, level of care, and facility type were assigned weights, the patient counts were
aggregated to create total weighted provincial or territorial patient counts. A distribution
across age and sex was generated and then applied to the appropriate provincial/territorial
NHEX figure for other institutions. The age groups from the RCF, (<10, 11–17, 18–44,
45-64, 65–69, 70–74, 75–79, 80–84, 85+), were expanded into 5-year age groups by
CIHI using population, as well as DAD/HMDB Weighted Cases that were also used to
distribute NHEX hospital expenditure (see age-sex distribution methodology for hospitals in
this section).
At the time of publication data was unavailable for Quebec for all years. The weighted
patient counts for Canada (minus Quebec) from the RCF for 1996/1997 to 1999/2000
was used as a proxy for Quebec’s distribution of other institutions expenditure. Estimates
for 1995/1996 and 2000/2001 were also generated using growth rates across age groups
and gender in the population, applied to the 1996/1997 and 1999/2000 other institutions
spending estimates by province and territory. Data was then converted into calendar year
(see Calculation Methods).
Drugs
Provincial government prescribed drug expenditure primarily includes drugs that are
dispensed through provincial drug subsidy programs. The level of coverage under these
programs varies across the country. Universal drug plans with first dollar coverage to all
residents are currently not available in any province. Most provincial government plans
provide prescribed drugs to seniors, and welfare recipients. British Columbia,
Saskatchewan and Manitoba provide some coverage to all residents with an assortment of
substantial individual deductibles and co-payments. Similarly, Quebec instituted a universal
plan in 1997 that requires Quebec residents to be covered under the provincial plan if a
private group plan, usually available through an employer, is not available.
CIHI requested drug claims that were paid in a given year, by age and sex from each
provincial drug subsidy program. Drug claim information by age and sex are currently
unavailable from Newfoundland, Prince Edward Island and Nunavut.
Data from Nova Scotia consists of the Seniors Pharmacare Program and prescription drug
claims paid by the Department of Community Services through the Income Assistance
Program and Family Benefits Program. Data from the Special Drug Program was
unavailable; expenditure for this plan was distributed using data from the Department of
Community Services.
Data collected from the New Brunswick Prescription Drug Program consists of ten different
drug plans. Age-sex data were provided for the following plans: Seniors Plan (A), Cystic
Fibrosis Plan (B), Family and Community Social Services (E), Human Resources
110
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Development (F), Organ Transplant (R), Human Growth Hormone (T), and Nursing Home
Program (V), leaving only three plans with no age and sex data: Children in Care (G), HIV
(U), and Special Authorization (SA) (for drugs not normally covered under the provincial
formulary). Beginning in October 1996, claims under SA are included in six other plans (A,
B, G, R, T, and V) if the claimant is a beneficiary of one of these plans. In September of
1997 this was expanded to include plans E and F. Minor plans for which age-sex data
were not available were distributed using the overall distribution of plans for which data
were available.
The Quebec Ministry of Health and Social Services supplied data on its drug subsidy
program in calendar year. The plans included coverage for seniors, income security
recipients, and others. Data for 1997 to 2000 also included a general client group
representing recipients whose drug claims are paid through the self financed drug
insurance fund by the premiums of subscribers to the plan and not the provincial
government. Consequently, the age-sex distribution of this group was not included
with the rest of the provincial government program.44
The Ontario Drug Benefits program (ODB) supplied age-sex data, which included combined
prescription drug claims paid by the Ministry of Health and the Ministry of Community
Services, as well as data for the Trillium Drug Program, which was implemented in
April 1995. The Special Drug Program does not have an age-sex profile; its expenditure
was therefore applied to the ODB distribution.
Manitoba was unable to provide data for fiscal year 1996/1997 because of the Drug
Programs Information Network (DPIN) conversion from a calendar year to a fiscal year
system. This resulted in a 15-month year from January 1996 to April 1997. The
Department of Health’s Pharmacare plan supplied data on drug claims paid for fiscal year
1997/1998 to 2000/2001. Data for the Ministry of Family Services, Employment and
Income Assistance Division’s drug plan was supplied for 1997/1998 to 2000/2001. The
figures reported for Manitoba in 1997 are based on fiscal year data for 1997/1998.
Data supplied by the Saskatchewan Drug Plan and Extended Benefits Branch was in
calendar year.
Alberta Health and Wellness provided expenditure data by age and sex on their prescription
drug programs from 1995/1996 to 2000/2001. Data was supplied for all four of Alberta’s
prescription drug plans: Seniors, Widow’s Pension, Regular and Palliative Care. Alberta
Human Resources and Employment provided data for their prescription drug expenditure
under the Employment and Income Assistance programs (formerly under Alberta Family
and Social Services) for 1995/1996 to 1998/1999 and 2000/2001. The age-sex
distribution for 1999/2000 Alberta Human Resources and Employment’s drug plan is based
on 1998/1999 data.
44
See the definition of Social Security Funds in the variables and concepts section of this report for more information.
111
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
British Columbia Ministry of Health of Health Services supplied claims paid by age and sex
of the client in calendar year from 1996 to 2000 for each plan administered by their
Pharmacare program. NHEX drug plan expenditures for British Columbia were converted
to calendar year and then applied to the distribution of the appropriate data supplied by the
province.
The Yukon Department of Health and Social Services supplied drug expenditure claims for
three administered drug plans: Seniors, Child Drug Plan, and Chronic Care Drug Plan. Data
from 1995/1996 to 2000/2001 was provided for each plan with the exception of the Child
Drug Plan, which was implemented in 1997/1998.
Northwest Territories Department of Health and Social Services supplied data by age and
sex for prescription drug claims paid for Extended Health Benefits (EHB).
The provincial government drug estimate at the program level is allocated to a given age
group based on the value of claims paid in that age group relative to total claims paid. In
provinces with more than one program, the age-sex-distributed programs were combined
to represent a total estimate for the province. Most data were collected in fiscal year and
converted to calendar year (see Calculation Methods).
Other Professionals
Expenditure for the category of other professionals accounted for approximately 1% of
total provincial/territorial health expenditure in 2000. Provincial/territorial governments
provide a variety of health services delivered by health professionals other than than
physicians that includes primarily dentists, optometrists, chiropractors and
physiotherapists. All provinces provide various programs for seniors and children, as well
as programs for income assistance recipients. However, the services provided vary
considerably across Canada. For instance, Ontario, British Columbia, and Quebec provide
physiotherapy services to residents, while other provinces do not. Chiropractic services are
provided through provincial insurance plans from Ontario west to British Columbia, but
nowhere else in Canada. Target populations, co-payments and deductibles also vary from
provinces to province. CIHI requested from each province data for claims that were paid
for by provincial/territorial governments in a given year, by age and sex, and type of
service provided by other health care professionals. Details of data availability and
estimation methods are described below.
Data was unavailable from Prince Edward Island, New Brunswick and Nunavut. The
remaining provinces and territories were able to supply data by age and sex for
approcismately75% or more of other professional services. When a province or territory
was unable to supply 100% of services, CIHI estimated the age and sex distribution for
these services by using data from programs from other provinces with similar coverage and
eligibility levels.
The provincial government expenditure estimates for other professionals at the program
level is allocated to a given age group based on the value of claims paid in that age group
relative to total claims paid. In provinces with more than one program the age-sexdistributed programs were combined to represent a total estimate for the provinces’ other
professionals expenditure. Most data were collected in fiscal year and converted to
calendar year (see Calculation Methods).
112
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Total Provincial Government Health Expenditure by Age and Sex
To age-sex standardize total provincial government health expenditures it is necessary that
all categories of expenditure be distributed by age and sex for each province. Unfortunately
age-sex distributions for all provincial/territorial government expenditures are currently not
available in all provinces and territories. Consequently, CIHI estimated the missing data
using the following methods. The age-sex distributions of drug subsidy programs for
Newfoundland, Prince Edward Island and Nunavut were estimated for 1998 to 2000 using
the distributions of drug subsidy programs in other provinces with similar target
populations and co-payment plans. Newfoundland’s age-sex distribution was based on
New Brunswick’s seniors and Community and Social Services drug plans (plans A, E and
F). Prince Edward Island’s age-sex distribution for drug expenditure was based on the Nova
Scotia Seniors and Community Services drug plans. Nunavut’s age-sex distribution is based
on the Northwest Territories data.
The age sex distributions of the category of other professionals in Prince Edward Island,
New Brunswick and Nunavut (1999 and 2000) were estimated for 1998 to 2000. The
age-sex distributions of these provinces were based on the distributions in other provinces
of other health care provider programs that had similar beneficiaries and co-payment plans.
Dental expenditure by age and sex in Prince Edward Island was based on the
Newfoundland Dental Health Plan clients from 3 to 16 years of age. Similarly, New
Brunswick’s dental expenditure for the youth income assistance plan was based on clients
up to 17 years of age from the Newfoundland dental plan. New Brunswick’s age and sex
distribution for the income assistance optometry plan was based on Saskatchewan
Health’s Supplementary Health Optometry plan. As was the case with Nunavut’s drug
expenditure, Nunavut’s other professional’s category expenditure was based on the agesex distribution for the Northwest Territories. Quebec’s physiotherapy expenditure is
distributed across a combined age-sex distribution of Ontario and British Columbia’s feefor-service physiotherapy plans.
Capital expenditure was estimated for all provinces and territories by using the general
provincial/territorial populations by age and sex. This method was used based on two
criteria: (i) capital investments in health care institutions typically last for decades and
those who do not use institutional services in a given year may use them in the future;
(ii) given the uncertainty of illness the availability of facilities has a value for all who
potentially would use them if the need arises.
The remaining categories of Public Health and Administration and Other Health Spending
were also estimated using the general provincial/territorial populations by age and sex
based on the following rationale. Public health and health research benefit the entire
population and it would be difficult to attribute them in different proportions to specific age
and sex groups. Prepayment administration expenditures are accounted for mainly by the
universal hospital and physicians’ services plans. The rationale for distributing them
according to the general population rather than based on utilization is because prepayment
administration expenses are made up largely of the costs of registration systems for eligible
residents, which cover the total population, and claims processing costs. The convention
of allocating ambulance expenditure by population distributions is not believed to result in
significant error of the total provincial expenditure distributions due to its small share of the
other health care spending category.
113
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Age-Sex Standardization of Provincial Government Expenditures
For the purpose of age-sex standardization CIHI used a direct method. Standardized
expenditures by category were calculated by multiplying the male and female population of
Canada in each of the 19 age groups by the expenditure per capita for each age group and
sex by province and territory. Male and female standardized expenditure was aggregated
and then divided by the total Canada population to generate the standardized per capita
spending for a particular category by province and territory.
M A J O R
C H A N G E S
F R O M
P R E V I O U S
Y E A R S
In the process of compiling the National Health Expenditure series new information
becomes available, methods and concepts are refined, and data sources are improved. The
data are revised to incorporate these enhancements.
Some data revisions in the provincial government sector can be attributed to the partial
implementation of recommendations from CIHI’s Public Health and Administration
Feasibility Study45. More specifically, the administrative costs associated with delivering
specific programs were matched with the program to which they applied. Previously these
administration expenses were reported entirely in the Public Health and Administration
category of expense. These revisions begin in 1985. Although no change in total
expenditures by provincial governments is reported for some years, categorical changes in
the expenditures may have occurred. For more information on these revisions please
contact CIHI at [email protected]
In 2002, Statistics Canada revised the capital series that is used in National Health
Expenditures, to include software expenditures. This revision affected the provincial
government sector, the private sector and the municipal government sector.
R E V I S I O N
H I S T O R Y
# Provincial Government Sector
Newfoundland— Updated historical information resulted in decreases of $0.3 million and
$0.1 million in 1989 and 1990 respectively. Capital revisions account for the differences
between 1991 and 1999. These revisions resulted in an increase in capital expenditures
ranging from $0.3 million in 1995 to $1.5 million in 1991.
Prince Edward Island—Capital revisions account for the differences between 1991 and
1999. These revisions resulted in an increase in capital expenditures ranging from
$0.3 million to $0.1 million.
45
Public Health and Administration in National Health Expenditures-Feasibility Study, CIHI, June 2002,
http://ottprd01:7778/cihiweb/dispPage.jsp?cw_page=spend_nhexenhance_e
114
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Nova Scotia—Capital in Nova Scotia was revised from 1991 and 1999 ranged from
$1.2 million to $1.6 million. Between 1990 and 1992 $0.1 million in administration
expenditures were allocated to capital and eventually dropped when capital data from
Statistics Canada was incorporated. A reclassification of capital debt of approximately
$0.5 million from administration to capital occurred in 1997 through 1999.
New Brunswick—Capital revisions account for the differences between 1991 and 1999.
These revisions resulted in an increase in capital expenditures ranging from $1.1 million
to $2.1 million.
Quebec—Capital revisions account for the differences between 1991 and 1999. These
revisions resulted in an increase in capital expenditures ranging from $15.5 million to
$31.3 million.
Ontario—As a result of new information the Health Resources Development Plan was reclassified from capital to health research from 1985 to 1991. Capital estimates in Ontario
were revised from 1991 and 1999 ranging from $16.2 million in 1991 to $45.8 million in
1999. One final revision was the omission of the Lieutenant Governor’s Board of Review
from 1985 to 1992.
Manitoba—Capital in Manitoba was revised from 1991 and 1999 ranged from $1.5 million
in 1991 to $1.6 million in 1999. Updated historical information resulted in an increase in
health expenditures of $100,000 in 1990.
Saskatchewan—Capital revisions account for the differences between 1991 and 1999.
These revisions resulted in an increase in capital expenditures ranging from $1.0 million in
1991 to $7.6 million in 1999.
Alberta—The category of capital was revised in Alberta between 1991 and 1999. The
revision impacted the final figures by between $7.8 million in 1991 and $11.9 million
in 1995. The allocation of administration expenditures to capital expenditures occurred
in 1991 through 1999 excluding 1993, 1994 and 1995. Ambulance expenditures were
revised downwards starting in 1995 based on new information from Alberta Health
and Wellness.
British Columbia—The category of capital was revised in British Columbia between 1991
and 1999. The revision ranged from $6.4 million in 1991 to $10.8 million in 1995. The
allocation of administration expenditures to capital programs account for further revisions
in 1985 through 1999 excluding 1995 and 1996.
Yukon—Capital revisions account for the differences between 1991 and 1997. These
revisions resulted in an increase in capital expenditures ranging from $0.1 million in 1997
to $0.7 million in 1996.
Northwest Territories—Capital revisions account for the differences between 1991
and 1999.These revisions resulted in an increase in capital expenditures ranging from
$0.1 million in 1999 to $0.5 million in 1991.
115
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Nunavut—The capital revision for 1999 in Nunavut totaled $0.1 million. Update
expenditure details lead to further minor revisions of the data (another $0.1 million).
The differences between the revised and original figures in the provincial government
sector for the provinces and territories, including revisions to the estimates of capital
expenditures, are summarized below (Table 9).
Table 15—Differences from Previously Reported Provincial Government Sector Data
by Province/Territory and Canada, 1985 to 1998
($ millions)
Year
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Nfld. P.E.I. N.S.
-------------------------0.3 -----0.1 ---0.1
1.5
0.1 -3.1
1.5
0.1 -0.2
1.3
0.2
1.4
1.0
0.2
1.4
0.3
0.2
1.4
0.8
0.3
1.6
0.9
0.1
1.4
0.3
0.3
1.6
1.0
0.2
1.7
N.B.
------------1.1
1.2
1.6
1.9
2.1
2.1
1.2
1.1
1.5
Que.
------------15.5
16.1
18.4
19.1
19.5
19.6
22.3
24.9
-65.5
Ont.
-0.7
-1.0
-1.0
10.2
14.2
17.3
31.3
36.1
42.2
47.1
40.2
41.0
50.1
44.9
47.2
Man. Sask. Alta.
------------------------------0.1 ----1.5
1.0
7.8
1.4
1.0
8.0
1.6
1.1
8.5
1.5
1.0
5.0
1.3
1.1
8.7
1.6
1.2
6.1
0.9
4.3
1.4
0.9
5.2
1.3
1.6
7.6
6.4
B.C.
------------6.4
7.0
8.3
9.3
10.8
10.7
7.5
15.6
9.7
Y.T. N.W.T. Nun. Canada
-------0.7
-------1.0
-------1.0
------10.2
------13.9
------17.3
0.4
0.5
--63.9
0.2
0.5
--72.9
0.4
0.4
--85.4
0.7
0.2
--88.4
0.2
0.1
--86.0
0.7
0.3
--86.0
0.1
0.2
--90.4
--0.1
--96.2
--0.1
0.2
11.9
# Private Sector
Capital expenditures in the private sector from 1991 to 1999 were affected by the
revisions to the Capital Survey administered by the Investment and Capital Stock Division
of Statistics Canada.
Hospital spending was updated in all jurisdictions excluding Newfoundland, New
Brunswick, Quebec and the Yukon in 1999 based on new data from the CMDB. Hospital
spending in Ontario was also revised in 1997 and 1998 and in the Northwest Territories in
1998 based on updated information from the CMDB.
Spending on Other Institutions in this sector was revised in New Brunswick, Ontario
Alberta, and British Columbia from 1996 to 1999 due to revised data from the Residential
Care Facilities Survey fielded by Statistics Canada.
Health research was also updated in most provinces in 1999.
Drug spending was revised in 1999 due to changes in the Survey of Household Spending
administered by Statistics Canada. The year 2000 was completely updated using the latest
AC Nielson data.
Total differences from 1991 to 1999 between the revised and previous expenditure
estimates in the private sector for the provinces and territories are listed below (Table 10).
116
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Table 16—Differences from Previously Reported Private Sector Data
by Province/Territory and Canada, 1991 to 1999
($ millions)
Year
1991
1992
1993
1994
1995
1996
1997
1998
1999
Nfld. P.E.I. N.S.
--0.1
0.6
-1.1 --0.4
-0.8 --0.5
-0.5 --0.5
1.0
0.1
0.4
--0.1
0.7
0.1
0.1
0.4
2.0 --0.4
2.5
2.1 -30.0
N.B. Que.
0.2 1.1
0.1 1.2
0.2 1.3
0.2 1.6
0.1 0.7
0.3 1.6
0.6 1.4
0.6 2.6
2.3 28.3
Ont. Man. Sask. Alta.
6.0
0.5
0.1
1.5
7.9
0.2 --2.8
9.4
0.2 --3.0
7.1
0.3 --1.9
14.2
0.2 --0.1
13.8
0.3
0.1
2.3
219.4 0.4
0.1
3.6
107.5 1.0
0.3
4.5
347.0 6.7
5.7 27.9
B.C.
1.9
1.8
2.2
2.7
1.7
2.7
3.7
2.2
16.3
Y.T. N.W.T. Nun. Canada
------12.0
------13.4
------16.0
------13.7
------18.4
------21.8
------229.7
--0.1
--121.1
0.4
0.4
0.3 409.8
# Federal Direct Sector
Since 1999, provincial level data in the federal direct sector have been collected directly
from federal departments and are augmented with information from the National Public
Accounts. This year, more detailed information was obtained for the historical data from
most federal departments such as the Department of Health Canada, Veterans Affairs
Canada (VAC) and National Defense. Consequently, the following revisions were made to
reflect this enhancement:
•
Updated information on occupational health expenditures was incorporated into the
database, leading to a downward revision in most years. Other Health was the category
affected most.
The differences between revised and original figures in each jurisdiction are summarized
below (Table 11).
Table 17—Differences from Previously Reported Federal Direct Sector Data
by Province/Territory and Canada, 1988 to 1999
($ millions)
Year
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Nfld. P.E.I. N.S. N.B.
-------------------------------------------------------------------------------------------------
Que.
---0.1
-0.2
-0.3
-0.2
-0.2
-0.2
-0.2
-0.2
-0.2
-0.2
8.0
Ont.
---0.1
-0.3
-0.4
-0.3
-0.2
-0.2
-0.3
-0.3
-0.3
-0.3
0.2
Man. Sask. Alta.
-----------------0.1
-----0.1
-----0.1
-----0.1
-----0.1
-----0.1
-----0.1
-----0.1
-----0.1
----0.1
117
B.C.
-----0.1
-0.1
-0.1
-0.1
-0.1
-0.1
-0.1
-0.1
-0.1
0.1
Y.T. N.W.T. Nun. Canada
------0.0
-------0.2
-------0.7
-------0.9
-------0.7
-------0.5
-------0.5
-------0.6
-------0.6
-------0.6
-------0.7
------8.4
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
# Municipal Government Sector
Spending on other institutions in this sector was discontinued in all jurisdictions from 1980
to 1999 based on recommendations of the Long Term Residential Care in National Health
Expenditures Feasibility Study. Municipal government data is from Statistics Canada’s
Financial Management System. It is understood that other institutions that are municipally
funded would likely be classified and included in the hospital category. Attempts to
estimate municipally funded other institutions would introduce a double count. The total
amounts of the revisions are listed below (Table 12).
Table 18—Differences from Previously Reported Municipal Government Sector Data
by Province/Territory and Canada, 1980 to 1999
($ millions)
Year
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Nfld. P.E.I. N.S. N.B.
-----6.0 -0.1
-----8.0 -------8.5 -------10.7 -------11.9 -------11.6 -------3.7 -------17.8 -------25.5 -------26.8 -------29.3 -------25.5 -------36.1 -------43.8 -------45.0 -------54.7 -------60.9 -----0.1 -63.4 -------55.4 -0.6
-----65.1 0.2
Que. Ont.
---2.5
---2.2
---1.9
---2.4
---0.7
---1.0
---4.6
---10.1
---7.4
---6.2
---7.8
---7.4
---7.1
---12.6
---20.6
---28.3
---36.3
---46.8
---47.6
-0.1 -109.2
Man.
----------------------0.4
0.4
0.5
0.5
0.6
0.5
0.1
-2.6
-8.9
Sask.
-0.1
-0.1
-----------0.1
-----------1.5
-2.4
-2.7
-16.7
-20.5
-33.7
-36.9
Alta.
---------------0.3
-0.1
----1.2
-0.2
0.8
5.7
---12.3
-5.3
-13.7
-22.5
B.C.
-0.1
-----------------------0.1
---------12.3
-10.4
-19.6
Y.T. N.W.T. Nun.
--------------------------------------------------------------------------------------------------------------------0.2
-0.1
Canada
-8.8
-10.2
-10.3
-13.0
-12.6
-12.6
-8.3
-28.4
-33.0
-32.9
-37.1
-31.3
-43.0
-56.7
-61.8
-85.1
-125.8
-148.4
-164.0
-262.0
# Social Security Fund Sector
Revisions in Nova Scotia are the result of new information from the Workers’
Compensation Board of Nova Scotia regarding the payment of physicians. Changes in
Ontario and British Columbia are the result of updated information. The revisions are
summarized below (Table 13).
118
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
Table 19—Differences from Previously Reported Social Security Fund Data
by Province/Territory and Canada, 1990 to 1999
($ millions)
Year
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Nfld. P.E.I.
--------------------------------0.0
0.0
-----
N.S.
1.3
3.8
3.6
3.3
3.8
2.9
2.5
2.6
0.0
3.3
N.B.
----------------0.0
---
Que.
----------------0.0
---
Ont. Man. Sask. Alta.
---------------------------------5.6
------35.8 ------106.7 ------74.7 ------0.0
0.0
0.0
0.0
61.4 -------
B.C.
--------------0.9
0.0
0.9
Y.T. N.W.T. Nun. Canada
------1.3
------3.8
------3.6
------3.3
-------1.8
------38.6
------109.2
------78.2
0.0
0.0
0.0
0.0
------65.7
# Age and Sex Expenditure Data
Changes to the age-sex distributions from the 2001 publication occurred due to
methodology revisions and new information from data sources. For more detailed
information please contact the NHEX section by telephone, (613) 241-7860 or by
e-mail [email protected]
# Economic and Demographic Data
Statistics Canada recently revised their population estimates. The estimates in this report
are now based on the latest released data of October 2002. As part of their overall revision
to the methods for measuring the nation's economic activity Statistics Canada also revised
estimates of Provincial Government Programs Spending; Provincial and National Gross
Domestic Product; and the Implicit Price Index for Government Current Expenditure used in
this report.
S O U R C E S
O F
D A T A
National Health Expenditure estimates are compiled based on information from the
following sources.
# Provincial Government Sector





Provincial Public Accounts and Main Estimates
Provincial Departments of Health Annual Reports and Statistical Supplements where
available
Annual Reports of various foundations, agencies and commissions
Special tabulations and specific information from various provincial departments
reporting health expenditures.
Federal Transfers as a part of Provincial Government spending:
−
EPF, CHST—Federal-Provincial Relations Division, Federal Department
of Finance
−
CAP—Cost Shared Programs Division, Human Resources and Development
Canada
119
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L
NOTES
−
Contributions to the Governments of the Northwest and Yukon Territories—
Public Accounts of Canada, Department of Indian Affairs and Northern
Development
−
Health Resource Fund—Health Canada
# Federal Direct Sector

Public Accounts of Canada

Special tabulations/information from:
−
Health Canada
−
Department of Veterans Affairs
−
Department of National Defense
−
−
−
−
Solicitor General of Canada
Statistics Canada
Citizenship and Immigration Canada
Several organizations that are responsible for administering research funds from
federal government such as Canada Foundation for Innovation, Canadian Health
Services Research Foundation and the Canadian Institute for Advanced Research
# Social Security Funds Sector

Special tabulations on medical aid spending provided by the provincial/territorial
Workers’ Compensation Boards

Annual Reports of provincial/territorial Workers’ Compensation Boards

Annual Report of the Régie de l’assurance-maladie du Québec
# Municipal Government Sector

Special tabulation purchased from the Public Institutions Division of
Statistics Canada.
# Private Sector


Private Insurance Component
−
The not-for-profit portion is captured from special tabulations provided by the
not-for-profit insurance companies.
−
The commercial portion is captured by a special tabulation provided by the
Canadian Life and Health Insurance Association (CLHIA).
Out-of-pocket Component
−
Survey of Household Spending, Statistics Canada (formerly the Family
Expenditures Survey (FAMEX)), except for the following categories
−
Hospitals—(adjusted income from patient services) Annual Return of Health Care
Facilities, fielded by Statistics Canada to 1994/1995, and the Annual Hospital
Survey fielded by CIHI from 1995/1996 to 2000/2001
120
NATIONAL HEALTH EXPENDITURE TRENDS M E T H O D O L O G I C A L

NOTES
−
Other Institutions—Residential Care Facilities Survey fielded by
Statistics Canada
−
Over-the-Counter Drugs and Personal Health Supplies—Market Review of
Selected Drug Categories at Retail, a special tabulation purchased from
AC Nielsen Canada
Non-consumption Component
− Hospitals—(adjusted income from non-patient services) Annual Return of Health
Care Facilities, Part 2 fielded by Statistics Canada to 1994/1995 and the Annual
Hospital Survey fielded by CIHI from 1995/1996 to 2000/2001
−
Capital Expenditures—special tabulation purchased from the Investment and
Capital Stock Division of Statistics Canada
−
Health Research—The Association of Canadian Medical Colleges, Canadian
Medical Education Statistics, Expenditure for Biomedical and Health Care
Research of Canadian Faculties of Medicine by Source of Funds
# Age and Sex Data

CIHI's Discharge Abstract Database (DAD) and Hospital Morbidity Database (HMDB)

CIHI's National Physician Database (NPDB)


Special tabulations provided by provincial/territorial government departments
responsible for administering drug and other health benefit programs
Statistic Canada’s Residential Care Facility Survey (RCF)
# Analytical Focus


1975/1976—1993/1994: Statistics Canada – Annual Return of Health Care
Facilities—Hospitals
1995/1996—1999/2001: Canadian Institute for Health Information—Canadian
MIS Database
# Economic and Demographic Data




Gross Domestic Product
− 1975–2001: purchased from National Accounts and Environment Division,
Statistics Canada
− 2002: purchased from the Conference Board of Canada (GDP growth rates)
Population: purchased from the Demography Division, Statistics Canada
Provincial Government Expenditure - Special tabulation purchased from the Public
Institutions Division of Statistics Canada
Price Indices
- 1975–2001: Income and Expenditure Accounts Division and Prices Division,
Statistics Canada
- 2002: purchased from Conference Board of Canada
121
NATIONAL HEALTH EXPENDITURE TRENDS D A T A
TABLES
Data Tables
This section provides summary level expenditure data. These data tables are organized
as follows:
Series
A—Summary Data, Canada
B—Total Health Expenditure, by Source of Finance, by Province/Territory and
Canada (Selected Tables)
E—Total Provincial/Territorial Government Health Expenditure, by Age and Sex, by
Province/Territory and Canada (Selected Tables)
The CD-ROM affixed to the back cover of this report contains more comprehensive data
tables in Microsoft® Excel©. The data tables on the CD are organized as follows:
Series available on the CD-ROM
A—Summary Data, Canada
B—Total Health Expenditure, by Source of Finance, by Province/Territory and Canada
C—Health Expenditure, by Use of Funds, by Source of Finance, Canada
D—Health Expenditure, by Use of Funds, Source of Finance, by Province/Territory
E—Provincial/Territorial Government Health Expenditure, by Selected Uses of Funds, by
Age and Sex, by Province/Territory and Canada
F—Provincial/Territorial Government Health Expenditure, by Province/Territory and Canada,
1974/1975 to 2002/2003
G— Hospital Expenditure by Functional Centre and Type of Expense, Canada
Each series generally follows the order below except as indicated. In addition, tables in
A.3, Series C, Series D, Series E, Series F.2 and F.3, and Series G are not available in
constant dollar values.
Current dollars
 in millions of dollars
 percentage distribution (Use of Funds and Series G only)
 per capita
 sector as a proportion of:
−
GDP (B.1 and F.1 series only)
−
total health expenditure (B.2 to B.8 series only)
−
total provincial/territorial government program/expenditure
(B.4 and F.4 series only)
Constant dollars
 in millions of 1997 dollars (A, B and F.1 series only)
 in 1997 dollars per capita (A, B and F.1 series only)
Most sub-series also include a table of annual percentage changes.
In all tables, forecasts are denoted with the letter “f” and the symbol “---“ denotes data
that is either unavailable or not applicable.
123
Series A
Summary Data, Canada
125
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.1
Total Health Expenditure, Canada, 1975 to 2002 - Summary
Total Health Expenditure
in current dollars
Total Health Expenditure
in constant 1997 dollars
Total Health Expenditure
as a % of GDP
Total
Per Capita
Total
Per Capita
Year
($' 000,000)
($)
($' 000,000)
($)
(%)
1975
1976
1977
1978
1979
12,200.6
14,051.1
15,451.2
17,108.4
19,170.1
527.20
599.20
651.23
713.92
792.08
39,695.7
40,778.3
41,621.1
42,953.6
44,216.2
1,715.29
1,738.96
1,754.21
1,792.43
1,826.95
7.0
7.0
7.0
7.0
6.8
1980
1981
1982
1983
1984
22,299.9
26,278.9
30,761.4
34,040.9
36,746.6
909.60
1,058.76
1,224.70
1,341.94
1,434.99
46,685.8
48,845.2
51,207.0
53,199.8
55,144.6
1,904.28
1,967.95
2,038.70
2,097.21
2,153.45
7.1
7.3
8.1
8.3
8.2
1985
1986
1987
1988
1989
39,845.2
43,340.7
46,791.9
50,959.8
56,096.3
1,541.84
1,660.53
1,769.08
1,901.60
2,055.85
57,565.3
60,361.7
62,047.0
64,726.6
67,646.6
2,227.54
2,312.66
2,345.83
2,415.32
2,479.15
8.2
8.5
8.4
8.3
8.5
1990
1991
1992
1993
1994
61,027.6
66,293.6
69,810.9
71,561.5
73,176.3
2,203.10
2,365.02
2,460.16
2,493.16
2,520.19
69,842.6
72,642.9
74,167.9
74,784.1
75,322.8
2,521.32
2,591.53
2,613.70
2,605.43
2,594.12
9.0
9.7
10.0
9.8
9.5
1995
1996
1997
1998
1999
74,120.5
74,779.7
78,574.2
83,634.6
89,788.6
2,525.07
2,520.22
2,620.26
2,764.92
2,942.99
75,546.5
75,695.0
78,574.2
82,471.3
87,467.2
2,573.65
2,551.07
2,620.26
2,726.47
2,866.90
9.1
8.9
8.9
9.1
9.2
97,420.0
105,605.2
112,213.0
3,163.93
3,394.51
3,572.07
92,541.8
98,691.7
101,952.9
3,005.50
3,172.29
3,245.46
9.1
9.7
9.8
2000
2001 f
2002 f
(annual percentage change)
1975
1976
1977
1978
1979
--15.2
10.0
10.7
12.1
--13.7
8.7
9.6
10.9
--2.7
2.1
3.2
2.9
--1.4
0.9
2.2
1.9
-----------
1980
1981
1982
1983
1984
16.3
17.8
17.1
10.7
7.9
14.8
16.4
15.7
9.6
6.9
5.6
4.6
4.8
3.9
3.7
4.2
3.3
3.6
2.9
2.7
-----------
1985
1986
1987
1988
1989
8.4
8.8
8.0
8.9
10.1
7.4
7.7
6.5
7.5
8.1
4.4
4.9
2.8
4.3
4.5
3.4
3.8
1.4
3.0
2.6
-----------
1990
1991
1992
1993
1994
8.8
8.6
5.3
2.5
2.3
7.2
7.3
4.0
1.3
1.1
3.2
4.0
2.1
0.8
0.7
1.7
2.8
0.9
-0.3
-0.4
-----------
1995
1996
1997
1998
1999
1.3
0.9
5.1
6.4
7.4
0.2
-0.2
4.0
5.5
6.4
0.3
0.2
3.8
5.0
6.1
-0.8
-0.9
2.7
4.1
5.2
-----------
2000
2001 f
2002 f
8.5
8.4
6.3
7.5
7.3
5.2
5.8
6.6
3.3
4.8
5.5
2.3
-------
f - Forecast
CIHI 2002
127
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.2.1
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002 - Current Dollars
Provincial
Government
Federal
Direct
Municipal
Government
Social
Security Funds
A
B
C
D
A+B+C+D
E
F
E+F
G
Year
Total of
Public
Sector
Private
Sector
Total
($' 000,000)
1975
1976
1977
1978
1979
8,710.4
10,131.2
11,103.3
12,271.1
13,697.0
398.3
439.7
475.2
485.6
512.8
71.6
105.8
114.2
111.7
156.0
121.1
141.9
153.1
173.8
186.8
9,301.4
10,818.5
11,845.8
13,042.1
14,552.7
2,899.2
3,232.6
3,605.4
4,066.3
4,617.4
12,200.6
14,051.1
15,451.2
17,108.4
19,170.1
1980
1981
1982
1983
1984
15,795.6
18,657.7
22,004.4
24,512.4
26,247.4
582.1
692.7
854.8
994.9
1,106.1
234.0
275.4
250.8
222.2
214.5
231.7
319.0
339.1
352.7
392.3
16,843.4
19,944.8
23,449.1
26,082.3
27,960.4
5,456.5
6,334.1
7,312.3
7,958.6
8,786.3
22,299.9
26,278.9
30,761.4
34,040.9
36,746.6
1985
1986
1987
1988
1989
28,205.7
30,504.0
32,824.6
35,806.9
39,332.1
1,157.7
1,260.8
1,349.7
1,522.8
1,686.6
273.1
310.2
404.6
303.5
326.4
462.0
457.0
479.5
531.1
566.8
30,098.4
32,532.0
35,058.4
38,164.3
41,911.9
9,746.9
10,808.7
11,733.5
12,795.4
14,184.3
39,845.2
43,340.7
46,791.9
50,959.8
56,096.3
1990
1991
1992
1993
1994
42,469.7
46,176.8
48,338.7
48,573.0
48,977.8
1,970.4
2,110.0
2,199.9
2,280.9
2,519.8
364.6
374.7
396.9
383.7
446.1
645.7
725.2
763.4
746.4
749.1
45,450.5
49,386.7
51,699.0
51,984.0
52,692.8
15,577.1
16,906.9
18,112.0
19,577.5
20,483.5
61,027.6
66,293.6
69,810.9
71,561.5
73,176.3
1995
1996
1997
1998
1999
48,967.1
49,095.5
50,904.0
54,198.2
58,091.4
2,667.0
2,606.3
2,850.0
3,052.3
3,370.2
394.9
348.1
318.7
765.4
570.1
793.2
825.9
950.6
1,046.3
1,172.7
52,822.2
52,875.7
55,023.2
59,062.3
63,204.4
21,298.3
21,904.0
23,550.9
24,572.3
26,584.2
74,120.5
74,779.7
78,574.2
83,634.6
89,788.6
2000
2001 f
2002 f
63,425.8
68,805.6
73,129.8
3,551.0
3,735.6
3,920.1
645.8
738.0
764.9
1,354.9
1,470.6
1,538.9
68,977.5
74,749.9
79,353.7
28,442.5
30,855.3
32,859.4
97,420.0
105,605.2
112,213.0
(annual percentage change)
1975
1976
1977
1978
1979
--16.3
9.6
10.5
11.6
--10.4
8.1
2.2
5.6
--47.6
7.9
-2.2
39.7
--17.2
8.0
13.5
7.5
--16.3
9.5
10.1
11.6
--11.5
11.5
12.8
13.6
--15.2
10.0
10.7
12.1
1980
1981
1982
1983
1984
15.3
18.1
17.9
11.4
7.1
13.5
19.0
23.4
16.4
11.2
50.0
17.7
-8.9
-11.4
-3.5
24.0
37.7
6.3
4.0
11.2
15.7
18.4
17.6
11.2
7.2
18.2
16.1
15.4
8.8
10.4
16.3
17.8
17.1
10.7
7.9
1985
1986
1987
1988
1989
7.5
8.1
7.6
9.1
9.8
4.7
8.9
7.1
12.8
10.8
27.3
13.6
30.4
-25.0
7.6
17.8
-1.1
4.9
10.8
6.7
7.6
8.1
7.8
8.9
9.8
10.9
10.9
8.6
9.1
10.9
8.4
8.8
8.0
8.9
10.1
1990
1991
1992
1993
1994
8.0
8.7
4.7
0.5
0.8
16.8
7.1
4.3
3.7
10.5
11.7
2.8
6.0
-3.3
16.2
13.9
12.3
5.3
-2.2
0.4
8.4
8.7
4.7
0.6
1.4
9.8
8.5
7.1
8.1
4.6
8.8
8.6
5.3
2.5
2.3
1995
1996
1997
1998
1999
0.0
0.3
3.7
6.5
7.2
5.8
-2.3
9.4
7.1
10.4
-11.5
-11.9
-8.4
140.2
-25.5
5.9
4.1
15.1
10.1
12.1
0.2
0.1
4.1
7.3
7.0
4.0
2.8
7.5
4.3
8.2
1.3
0.9
5.1
6.4
7.4
2000
2001 f
2002 f
9.2
8.5
6.3
5.4
5.2
4.9
13.3
14.3
3.6
15.5
8.5
4.6
9.1
8.4
6.2
7.0
8.5
6.5
8.5
8.4
6.3
f - Forecast
CIHI 2002
129
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.2.2
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002 - Current Dollars
Provincial
Government
Federal
Direct
Municipal
Government
Social
Security Funds
A
B
C
D
Year
Total of
Public
Sector
A+B+C+D
E
Private
Sector
Total
F
E+F
G
(percentage distribution of $' 000,000)
1975
1976
1977
1978
1979
71.4
72.1
71.9
71.7
71.4
3.3
3.1
3.1
2.8
2.7
0.6
0.8
0.7
0.7
0.8
1.0
1.0
1.0
1.0
1.0
76.2
77.0
76.7
76.2
75.9
23.8
23.0
23.3
23.8
24.1
100.0
100.0
100.0
100.0
100.0
1980
1981
1982
1983
1984
70.8
71.0
71.5
72.0
71.4
2.6
2.6
2.8
2.9
3.0
1.0
1.0
0.8
0.7
0.6
1.0
1.2
1.1
1.0
1.1
75.5
75.9
76.2
76.6
76.1
24.5
24.1
23.8
23.4
23.9
100.0
100.0
100.0
100.0
100.0
1985
1986
1987
1988
1989
70.8
70.4
70.2
70.3
70.1
2.9
2.9
2.9
3.0
3.0
0.7
0.7
0.9
0.6
0.6
1.2
1.1
1.0
1.0
1.0
75.5
75.1
74.9
74.9
74.7
24.5
24.9
25.1
25.1
25.3
100.0
100.0
100.0
100.0
100.0
1990
1991
1992
1993
1994
69.6
69.7
69.2
67.9
66.9
3.2
3.2
3.2
3.2
3.4
0.6
0.6
0.6
0.5
0.6
1.1
1.1
1.1
1.0
1.0
74.5
74.5
74.1
72.6
72.0
25.5
25.5
25.9
27.4
28.0
100.0
100.0
100.0
100.0
100.0
1995
1996
1997
1998
1999
66.1
65.7
64.8
64.8
64.7
3.6
3.5
3.6
3.6
3.8
0.5
0.5
0.4
0.9
0.6
1.1
1.1
1.2
1.3
1.3
71.3
70.7
70.0
70.6
70.4
28.7
29.3
30.0
29.4
29.6
100.0
100.0
100.0
100.0
100.0
2000
2001 f
2002 f
65.1
65.2
65.2
3.6
3.5
3.5
0.7
0.7
0.7
1.4
1.4
1.4
70.8
70.8
70.7
29.2
29.2
29.3
100.0
100.0
100.0
(annual percentage change)
1975
1976
1977
1978
1979
--1.0
-0.3
-0.2
-0.4
---4.1
-1.7
-7.7
-5.8
--28.2
-1.9
-11.6
24.7
--1.7
-1.8
2.5
-4.1
--1.0
-0.4
-0.6
-0.4
---3.2
1.4
1.9
1.3
-----------
1980
1981
1982
1983
1984
-0.9
0.2
0.8
0.7
-0.8
-2.4
1.0
5.4
5.2
3.0
28.9
-0.1
-22.2
-19.9
-10.6
6.6
16.8
-9.2
-6.0
3.0
-0.5
0.5
0.4
0.5
-0.7
1.6
-1.5
-1.4
-1.6
2.3
-----------
1985
1986
1987
1988
1989
-0.9
-0.6
-0.3
0.2
-0.2
-3.5
0.1
-0.8
3.6
0.6
17.4
4.4
20.8
-31.1
-2.3
8.6
-9.1
-2.8
1.7
-3.1
-0.7
-0.6
-0.2
0.0
-0.2
2.3
2.0
0.5
0.1
0.7
-----------
1990
1991
1992
1993
1994
-0.7
0.1
-0.6
-2.0
-1.4
7.4
-1.4
-1.0
1.1
8.0
2.7
-5.4
0.6
-5.7
13.7
4.7
3.4
0.0
-4.6
-1.9
-0.3
0.0
-0.6
-1.9
-0.9
0.9
-0.1
1.7
5.4
2.3
-----------
1995
1996
1997
1998
1999
-1.3
-0.6
-1.3
0.0
-0.2
4.5
-3.1
4.1
0.6
2.8
-12.6
-12.6
-12.9
125.7
-30.6
4.5
3.2
9.5
3.4
4.4
-1.0
-0.8
-1.0
0.8
-0.3
2.7
1.9
2.3
-2.0
0.8
-----------
0.6
0.7
0.1
-2.9
-5.8
-4.2
4.4
10.1
2.8
6.5
6.6
-1.4
0.6
0.6
-0.1
-1.4
-1.3
0.3
-------
2000
2001 f
2002 f
f - Forecast
CIHI 2002
130
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.2.3
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002 - Current Dollars
Provincial
Government
Federal
Direct
Municipal
Government
Social
Security Funds
A
B
C
D
Year
Total of
Public
Sector
Private
Sector
Total
A+B+C+D
E
F
E+F
G
($' per capita)
1975
1976
1977
1978
1979
376.38
432.04
467.97
512.06
565.94
17.21
18.75
20.03
20.26
21.19
3.10
4.51
4.81
4.66
6.45
5.23
6.05
6.45
7.25
7.72
401.92
461.35
499.27
544.24
601.30
125.28
137.85
151.96
169.68
190.78
527.20
599.20
651.23
713.92
792.08
1980
1981
1982
1983
1984
644.29
751.71
876.06
966.31
1,024.99
23.74
27.91
34.03
39.22
43.20
9.54
11.10
9.99
8.76
8.38
9.45
12.85
13.50
13.90
15.32
687.03
803.56
933.58
1,028.20
1,091.88
222.57
255.20
291.12
313.74
343.11
909.60
1,058.76
1,224.70
1,341.94
1,434.99
1985
1986
1987
1988
1989
1,091.44
1,168.71
1,241.01
1,336.16
1,441.46
44.80
48.30
51.03
56.83
61.81
10.57
11.88
15.30
11.33
11.96
17.88
17.51
18.13
19.82
20.77
1,164.68
1,246.41
1,325.46
1,424.13
1,536.01
377.16
414.12
443.61
477.47
519.84
1,541.84
1,660.53
1,769.08
1,901.60
2,055.85
1990
1991
1992
1993
1994
1,533.16
1,647.36
1,703.47
1,692.25
1,686.80
71.13
75.27
77.53
79.47
86.78
13.16
13.37
13.99
13.37
15.36
23.31
25.87
26.90
26.01
25.80
1,640.76
1,761.87
1,821.89
1,811.09
1,814.74
562.33
603.15
638.27
682.07
705.45
2,203.10
2,365.02
2,460.16
2,493.16
2,520.19
1995
1996
1997
1998
1999
1,668.17
1,654.61
1,697.53
1,791.77
1,904.05
90.86
87.84
95.04
100.91
110.46
13.45
11.73
10.63
25.30
18.69
27.02
27.83
31.70
34.59
38.44
1,799.50
1,782.01
1,834.89
1,952.58
2,071.64
725.57
738.21
785.37
812.35
871.35
2,525.07
2,520.22
2,620.26
2,764.92
2,942.99
2000
2001 f
2002 f
2,059.89
2,211.65
2,327.94
115.33
120.07
124.79
20.97
23.72
24.35
44.00
47.27
48.99
2,240.20
2,402.72
2,526.06
923.73
991.80
1,046.01
3,163.93
3,394.51
3,572.07
(annual percentage change)
1975
1976
1977
1978
1979
--14.8
8.3
9.4
10.5
--9.0
6.8
1.2
4.6
--45.7
6.7
-3.1
38.3
--15.6
6.7
12.3
6.5
--14.8
8.2
9.0
10.5
--10.0
10.2
11.7
12.4
--13.7
8.7
9.6
10.9
1980
1981
1982
1983
1984
13.8
16.7
16.5
10.3
6.1
12.0
17.5
21.9
15.2
10.1
48.1
16.2
-10.0
-12.3
-4.4
22.4
36.0
5.0
3.0
10.2
14.3
17.0
16.2
10.1
6.2
16.7
14.7
14.1
7.8
9.4
14.8
16.4
15.7
9.6
6.9
1985
1986
1987
1988
1989
6.5
7.1
6.2
7.7
7.9
3.7
7.8
5.6
11.4
8.8
26.1
12.5
28.7
-26.0
5.6
16.7
-2.1
3.5
9.3
4.8
6.7
7.0
6.3
7.4
7.9
9.9
9.8
7.1
7.6
8.9
7.4
7.7
6.5
7.5
8.1
1990
1991
1992
1993
1994
6.4
7.4
3.4
-0.7
-0.3
15.1
5.8
3.0
2.5
9.2
10.0
1.5
4.7
-4.4
14.9
12.2
11.0
4.0
-3.3
-0.8
6.8
7.4
3.4
-0.6
0.2
8.2
7.3
5.8
6.9
3.4
7.2
7.3
4.0
1.3
1.1
1995
1996
1997
1998
1999
-1.1
-0.8
2.6
5.6
6.3
4.7
-3.3
8.2
6.2
9.5
-12.4
-12.8
-9.4
138.1
-26.2
4.7
3.0
13.9
9.1
11.1
-0.8
-1.0
3.0
6.4
6.1
2.9
1.7
6.4
3.4
7.3
0.2
-0.2
4.0
5.5
6.4
8.2
7.4
5.3
4.4
4.1
3.9
12.2
13.1
2.6
14.5
7.4
3.6
8.1
7.3
5.1
6.0
7.4
5.5
7.5
7.3
5.2
2000
2001 f
2002 f
f - Forecast
CIHI 2002
131
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.2.4
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002 - Constant Dollars
Provincial
Government
Federal
Direct
Municipal
Government
Social
Security Funds
A
B
C
D
Year
Total of
Public
Sector
Private
Sector
Total
A+B+C+D
E
F
E+F
G
(in 1997 $' 000,000)
1975
1976
1977
1978
1979
27,838.6
28,663.9
28,974.1
29,830.9
30,369.4
1,272.2
1,247.3
1,243.4
1,184.5
1,140.9
230.4
304.7
304.7
277.9
354.1
389.4
403.8
402.6
425.3
417.5
29,730.5
30,619.7
30,924.8
31,718.7
32,281.9
9,965.1
10,158.6
10,696.2
11,234.9
11,934.4
39,695.7
40,778.3
41,621.1
42,953.6
44,216.2
1980
1981
1982
1983
1984
31,778.5
33,252.6
35,201.6
37,131.6
38,321.4
1,174.0
1,237.4
1,373.2
1,506.6
1,612.1
482.4
501.6
410.0
342.1
318.2
469.8
572.9
545.8
539.1
575.8
33,904.7
35,564.5
37,530.7
39,519.4
40,827.5
12,781.1
13,280.7
13,676.3
13,680.3
14,317.1
46,685.8
48,845.2
51,207.0
53,199.8
55,144.6
1985
1986
1987
1988
1989
39,769.3
41,684.9
42,971.3
45,162.3
47,088.3
1,631.6
1,721.7
1,767.8
1,921.0
2,019.6
389.2
423.9
526.9
382.4
389.3
652.4
625.7
628.6
671.2
678.3
42,442.5
44,456.2
45,894.7
48,136.9
50,175.5
15,122.9
15,905.5
16,152.3
16,589.7
17,471.1
57,565.3
60,361.7
62,047.0
64,726.6
67,646.6
1990
1991
1992
1993
1994
48,231.6
50,329.7
51,155.8
50,753.8
50,382.0
2,239.2
2,305.5
2,336.9
2,393.7
2,599.1
413.7
409.0
420.6
401.3
461.7
733.8
790.0
807.3
779.6
771.4
51,618.3
53,834.1
54,720.6
54,328.4
54,214.1
18,224.3
18,808.8
19,447.3
20,455.7
21,108.7
69,842.6
72,642.9
74,167.9
74,784.1
75,322.8
1995
1996
1997
1998
1999
49,804.4
49,651.3
50,904.0
53,625.6
57,037.5
2,717.5
2,637.2
2,850.0
3,019.9
3,309.3
403.6
353.2
318.7
753.8
563.7
807.7
835.9
950.6
1,036.8
1,147.7
53,733.2
53,477.6
55,023.2
58,436.0
62,058.3
21,813.4
22,217.3
23,550.9
24,035.3
25,409.0
75,546.5
75,695.0
78,574.2
82,471.3
87,467.2
2000
2001 f
2002 f
60,621.0
64,986.3
66,901.2
3,391.5
3,528.4
3,581.9
627.0
708.6
715.4
1,285.0
1,377.8
1,395.6
65,924.6
70,601.1
72,594.1
26,617.2
28,090.6
29,358.8
92,541.8
98,691.7
101,952.9
(annual percentage change)
1975
1976
1977
1978
1979
--3.0
1.1
3.0
1.8
---2.0
-0.3
-4.7
-3.7
--32.2
0.0
-8.8
27.4
--3.7
-0.3
5.6
-1.8
--3.0
1.0
2.6
1.8
--1.9
5.3
5.0
6.2
--2.7
2.1
3.2
2.9
1980
1981
1982
1983
1984
4.6
4.6
5.9
5.5
3.2
2.9
5.4
11.0
9.7
7.0
36.2
4.0
-18.3
-16.6
-7.0
12.5
21.9
-4.7
-1.2
6.8
5.0
4.9
5.5
5.3
3.3
7.1
3.9
3.0
0.0
4.7
5.6
4.6
4.8
3.9
3.7
1985
1986
1987
1988
1989
3.8
4.8
3.1
5.1
4.3
1.2
5.5
2.7
8.7
5.1
22.3
8.9
24.3
-27.4
1.8
13.3
-4.1
0.5
6.8
1.1
4.0
4.7
3.2
4.9
4.2
5.6
5.2
1.6
2.7
5.3
4.4
4.9
2.8
4.3
4.5
1990
1991
1992
1993
1994
2.4
4.3
1.6
-0.8
-0.7
10.9
3.0
1.4
2.4
8.6
6.3
-1.1
2.8
-4.6
15.0
8.2
7.7
2.2
-3.4
-1.1
2.9
4.3
1.6
-0.7
-0.2
4.3
3.2
3.4
5.2
3.2
3.2
4.0
2.1
0.8
0.7
1995
1996
1997
1998
1999
-1.1
-0.3
2.5
5.3
6.4
4.6
-3.0
8.1
6.0
9.6
-12.6
-12.5
-9.8
136.6
-25.2
4.7
3.5
13.7
9.1
10.7
-0.9
-0.5
2.9
6.2
6.2
3.3
1.9
6.0
2.1
5.7
0.3
0.2
3.8
5.0
6.1
6.3
7.2
2.9
2.5
4.0
1.5
11.2
13.0
1.0
12.0
7.2
1.3
6.2
7.1
2.8
4.8
5.5
4.5
5.8
6.6
3.3
2000
2001 f
2002 f
f - Forecast
CIHI 2002
132
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.2.5
Total Health Expenditure by Source of Finance, Canada, 1975 to 2002 - Constant Dollars
Provincial
Government
Federal
Direct
Municipal
Government
Social
Security Funds
A
B
C
D
Year
Total of
Public
Sector
Private
Sector
Total
A+B+C+D
E
F
E+F
G
(in 1997 $' per capita)
1975
1976
1977
1978
1979
1,202.93
1,222.35
1,221.18
1,244.82
1,254.82
54.97
53.19
52.40
49.43
47.14
9.96
12.99
12.84
11.60
14.63
16.82
17.22
16.97
17.75
17.25
1,284.69
1,305.75
1,303.40
1,323.60
1,333.84
430.60
433.21
450.82
468.83
493.11
1,715.29
1,738.96
1,754.21
1,792.43
1,826.95
1980
1981
1982
1983
1984
1,296.22
1,339.73
1,401.48
1,463.78
1,496.49
47.89
49.85
54.67
59.39
62.96
19.68
20.21
16.33
13.49
12.42
19.16
23.08
21.73
21.25
22.48
1,382.95
1,432.88
1,494.21
1,557.91
1,594.35
521.33
535.07
544.49
539.30
559.10
1,904.28
1,967.95
2,038.70
2,097.21
2,153.45
1985
1986
1987
1988
1989
1,538.90
1,597.09
1,624.63
1,685.27
1,725.71
63.14
65.96
66.84
71.68
74.02
15.06
16.24
19.92
14.27
14.27
25.24
23.97
23.77
25.05
24.86
1,642.35
1,703.27
1,735.16
1,796.27
1,838.86
585.19
609.39
610.67
619.06
640.29
2,227.54
2,312.66
2,345.83
2,415.32
2,479.15
1990
1991
1992
1993
1994
1,741.16
1,795.51
1,802.75
1,768.23
1,735.16
80.83
82.25
82.35
83.40
89.51
14.93
14.59
14.82
13.98
15.90
26.49
28.18
28.45
27.16
26.57
1,863.42
1,920.53
1,928.37
1,892.77
1,867.14
657.90
671.00
685.33
712.66
726.98
2,521.32
2,591.53
2,613.70
2,605.43
2,594.12
1995
1996
1997
1998
1999
1,696.69
1,673.35
1,697.53
1,772.84
1,869.51
92.58
88.88
95.04
99.84
108.47
13.75
11.90
10.63
24.92
18.48
27.52
28.17
31.70
34.28
37.62
1,830.53
1,802.30
1,834.89
1,931.87
2,034.08
743.12
748.77
785.37
794.60
832.83
2,573.65
2,551.07
2,620.26
2,726.47
2,866.90
2000
2001 f
2002 f
1,968.80
2,088.88
2,129.66
110.15
113.42
114.02
20.36
22.78
22.77
41.73
44.29
44.43
2,141.05
2,269.36
2,310.88
864.45
902.93
934.58
3,005.50
3,172.29
3,245.46
(annual percentage change)
1975
1976
1977
1978
1979
--1.6
-0.1
1.9
0.8
---3.2
-1.5
-5.7
-4.6
--30.5
-1.1
-9.7
26.1
--2.4
-1.5
4.6
-2.8
--1.6
-0.2
1.6
0.8
--0.6
4.1
4.0
5.2
--1.4
0.9
2.2
1.9
1980
1981
1982
1983
1984
3.3
3.4
4.6
4.4
2.2
1.6
4.1
9.7
8.6
6.0
34.5
2.7
-19.2
-17.4
-7.9
11.1
20.4
-5.9
-2.2
5.8
3.7
3.6
4.3
4.3
2.3
5.7
2.6
1.8
-1.0
3.7
4.2
3.3
3.6
2.9
2.7
1985
1986
1987
1988
1989
2.8
3.8
1.7
3.7
2.4
0.3
4.5
1.3
7.3
3.3
21.2
7.9
22.7
-28.4
0.0
12.3
-5.0
-0.9
5.4
-0.7
3.0
3.7
1.9
3.5
2.4
4.7
4.1
0.2
1.4
3.4
3.4
3.8
1.4
3.0
2.6
1990
1991
1992
1993
1994
0.9
3.1
0.4
-1.9
-1.9
9.2
1.7
0.1
1.3
7.3
4.7
-2.3
1.6
-5.7
13.7
6.6
6.4
1.0
-4.5
-2.2
1.3
3.1
0.4
-1.8
-1.4
2.8
2.0
2.1
4.0
2.0
1.7
2.8
0.9
-0.3
-0.4
1995
1996
1997
1998
1999
-2.2
-1.4
1.4
4.4
5.5
3.4
-4.0
6.9
5.0
8.6
-13.5
-13.4
-10.7
134.5
-25.9
3.6
2.4
12.5
8.1
9.7
-2.0
-1.5
1.8
5.3
5.3
2.2
0.8
4.9
1.2
4.8
-0.8
-0.9
2.7
4.1
5.2
5.3
6.1
2.0
1.5
3.0
0.5
10.2
11.9
0.0
10.9
6.1
0.3
5.3
6.0
1.8
3.8
4.5
3.5
4.8
5.5
2.3
2000
2001 f
2002 f
f - Forecast
CIHI 2002
133
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.1—Part 1
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' 000,000)
1975
5,454.8
1,124.3
1,839.9
740.1
226.1
128.4
1,094.6
1976
6,357.3
1,367.7
2,071.0
867.4
260.1
145.5
1,273.0
1977
6,791.9
1,575.9
2,284.4
1,033.0
295.8
162.6
1,491.4
1978
7,380.6
1,850.3
2,566.7
1,189.4
336.0
186.3
1,711.7
1979
8,113.5
2,169.5
2,857.0
1,372.2
365.7
219.2
1,957.2
1980
9,333.7
2,536.2
3,287.5
1,590.3
414.3
255.4
2,260.0
1981
11,029.6
2,882.0
3,824.8
1,809.7
513.6
303.7
2,626.9
1982
13,091.3
3,356.8
4,420.8
2,070.4
609.8
357.3
3,037.5
1983
14,416.5
3,727.9
5,052.7
2,223.6
715.0
411.6
3,350.2
1984
15,343.8
3,907.2
5,525.8
2,400.3
829.2
452.2
3,681.7
4,133.0
1985
16,260.1
4,103.2
6,045.7
2,710.8
925.8
496.4
1986
17,637.2
4,087.2
6,674.8
2,959.6
1,002.2
562.0
4,523.8
1987
18,951.1
4,329.2
7,342.8
3,203.6
1,075.6
634.3
4,913.5
5,393.4
1988
20,400.3
4,738.7
7,942.5
3,494.0
1,184.2
715.2
1989
22,236.5
5,141.3
8,507.2
3,820.7
1,302.3
833.2
5,956.2
1990
23,819.9
5,748.2
9,247.2
4,139.0
1,402.7
955.9
6,497.6
7,034.0
1991
25,662.0
6,344.9
10,210.3
4,467.5
1,484.8
1,081.7
1992
26,653.5
6,787.1
10,453.6
4,690.2
1,535.0
1,170.1
7,395.4
1993
26,739.5
6,794.8
10,503.8
4,926.9
1,587.0
1,218.7
7,732.7
1994
26,246.5
6,920.1
10,736.9
5,216.5
1,683.0
1,250.3
8,149.8
1995
25,645.1
7,130.2
10,642.2
5,485.0
1,774.4
1,307.8
8,567.3
1996
25,459.7
7,251.2
10,763.7
5,663.4
1,830.1
1,349.5
8,843.0
1997
26,202.5
7,504.7
11,182.2
5,896.7
2,188.3
1,556.8
9,641.8
1998
27,560.8
7,808.4
11,722.3
6,279.3
2,275.3
1,540.0
10,094.6
1999
28,718.1
8,543.6
12,228.9
6,774.0
2,346.0
1,738.9
10,858.8
2000
2001 f
2002 f
31,245.3
33,076.1
35,159.3
9,139.2
9,779.1
10,399.5
12,999.6
14,017.1
15,010.3
7,204.1
7,701.6
8,036.6
2,573.8
2,774.9
2,924.8
1,825.5
1,964.5
2,054.1
11,603.4
12,441.0
13,015.4
(annual percentage change)
1975
---
---
---
---
---
---
---
1976
16.5
21.7
12.6
17.2
15.0
13.3
16.3
1977
6.8
15.2
10.3
19.1
13.7
11.7
17.2
1978
8.7
17.4
12.4
15.1
13.6
14.6
14.8
1979
9.9
17.3
11.3
15.4
8.9
17.6
14.3
1980
15.0
16.9
15.1
15.9
13.3
16.5
15.5
1981
18.2
13.6
16.3
13.8
24.0
18.9
16.2
1982
18.7
16.5
15.6
14.4
18.7
17.7
15.6
1983
10.1
11.1
14.3
7.4
17.3
15.2
10.3
1984
6.4
4.8
9.4
7.9
16.0
9.8
9.9
12.3
1985
6.0
5.0
9.4
12.9
11.6
9.8
1986
8.5
-0.4
10.4
9.2
8.2
13.2
9.5
1987
7.4
5.9
10.0
8.2
7.3
12.9
8.6
1988
7.6
9.5
8.2
9.1
10.1
12.8
9.8
1989
9.0
8.5
7.1
9.3
10.0
16.5
10.4
1990
7.1
11.8
8.7
8.3
7.7
14.7
9.1
1991
7.7
10.4
10.4
7.9
5.8
13.2
8.3
1992
3.9
7.0
2.4
5.0
3.4
8.2
5.1
1993
0.3
0.1
0.5
5.0
3.4
4.2
4.6
1994
-1.8
1.8
2.2
5.9
6.1
2.6
5.4
1995
-2.3
3.0
-0.9
5.1
5.4
4.6
5.1
1996
-0.7
1.7
1.1
3.3
3.1
3.2
3.2
1997
2.9
3.5
3.9
4.1
19.6
15.4
9.0
1998
5.2
4.0
4.8
6.5
4.0
-1.1
4.7
1999
4.2
9.4
4.3
7.9
3.1
12.9
7.6
2000
2001 f
2002 f
8.8
5.9
6.3
7.0
7.0
6.3
6.3
7.8
7.1
6.4
6.9
4.3
9.7
7.8
5.4
5.0
7.6
4.6
6.9
7.2
4.6
f - Forecast
CIHI 2002
134
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.1—Part 2
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' 000,000)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
770.6
305.6
1,076.2
536.1
514.9
211.8
94.8
253.1
559.7
12,200.6
881.9
316.0
1,197.9
544.1
630.4
212.7
106.7
290.3
609.7
14,051.1
985.0
324.5
1,309.5
563.7
720.4
248.2
130.7
335.1
714.0
15,451.2
1,049.2
392.8
1,442.0
672.2
714.7
257.8
151.8
360.6
770.2
17,108.4
1,159.8
495.5
1,655.3
725.1
808.1
286.8
173.6
424.0
884.3
19,170.1
1,295.2
586.3
1,881.5
990.7
950.5
318.3
203.0
538.4
1,059.7
22,299.9
1,673.9
655.0
2,328.9
1,111.2
1,117.2
417.3
232.2
708.8
1,358.3
26,278.9
1,920.9
715.0
2,635.9
1,394.8
1,332.6
407.8
258.8
825.1
1,491.7
30,761.4
2,103.8
845.9
2,949.6
1,436.6
1,435.3
434.1
297.9
940.1
1,672.2
34,040.9
2,252.2
1,058.6
3,310.8
1,504.1
1,591.3
520.7
337.8
1,023.3
1,881.8
36,746.6
2,565.6
1,235.9
3,801.5
1,651.2
1,788.8
513.4
383.8
1,164.6
2,061.8
39,845.2
3,018.0
1,399.0
4,417.1
1,801.4
1,840.7
570.4
456.1
1,332.0
2,358.5
43,340.7
3,293.1
1,621.7
4,914.9
1,871.8
1,946.8
576.5
455.6
1,489.6
2,521.8
46,791.9
3,736.8
1,784.9
5,521.7
1,901.7
2,059.8
737.4
508.6
1,755.6
3,001.6
50,959.8
4,262.9
1,975.6
6,238.5
2,092.8
2,297.3
987.7
589.0
2,049.8
3,626.4
56,096.3
4,871.8
2,058.7
6,930.5
2,123.7
2,570.1
1,002.5
671.4
2,416.6
4,090.5
61,027.6
5,468.6
2,236.6
7,705.3
2,027.5
2,806.1
1,092.5
699.3
2,711.8
4,503.7
66,293.6
6,100.7
2,418.1
8,518.8
2,058.0
3,073.3
1,161.2
808.2
2,901.9
4,871.3
69,810.9
6,603.5
2,576.0
9,179.6
2,016.9
3,241.5
1,410.2
793.4
3,149.2
5,352.8
71,561.5
6,760.9
2,676.6
9,437.5
2,272.8
3,623.9
1,568.7
801.4
3,418.6
5,788.7
73,176.3
7,399.0
2,703.6
10,102.6
2,263.1
3,786.8
1,617.6
808.4
3,557.2
5,983.2
74,120.5
7,602.1
2,756.0
10,358.1
2,160.0
3,912.4
1,651.7
821.1
3,558.7
6,031.6
74,779.7
8,531.3
2,877.5
11,408.8
2,122.0
3,956.0
1,633.3
1,114.4
3,808.4
6,556.1
78,574.2
9,451.3
3,067.0
12,518.3
2,298.3
4,760.7
1,494.4
1,219.9
4,156.9
6,871.2
83,634.6
10,239.8
3,252.3
13,492.1
3,108.5
5,159.4
1,693.9
1,396.6
4,588.6
7,679.1
89,788.6
11,728.3
13,396.7
14,572.9
3,322.6
3,441.1
3,564.0
15,051.0
16,837.8
18,136.8
3,513.4
4,405.1
4,826.1
5,796.8
6,483.2
6,676.5
1,888.8
2,017.0
2,171.5
1,268.0
1,289.1
1,409.3
4,914.7
5,259.7
5,408.2
8,071.5
8,565.8
8,988.9
97,420.0
105,605.2
112,213.0
(annual percentage change)
--14.4
--3.4
--11.3
---
---
1.5
22.4
0.4
12.5
14.7
8.9
15.2
---
---
---
---
---
11.7
2.7
9.3
3.6
14.3
16.7
22.5
15.4
17.1
10.0
6.5
21.1
10.1
19.2
-0.8
3.9
16.2
7.6
7.9
10.7
10.5
26.2
14.8
7.9
13.1
11.2
14.4
17.6
14.8
12.1
11.7
18.3
13.7
36.6
17.6
11.0
16.9
27.0
19.8
16.3
29.2
11.7
23.8
12.2
17.5
31.1
14.4
31.7
28.2
17.8
14.8
9.2
13.2
25.5
19.3
-2.3
11.5
16.4
9.8
17.1
9.5
18.3
11.9
3.0
7.7
6.5
15.1
13.9
12.1
10.7
7.1
25.2
12.2
4.7
10.9
19.9
13.4
8.8
12.5
7.9
13.9
16.7
14.8
9.8
12.4
-1.4
13.6
13.8
9.6
8.4
17.6
13.2
16.2
9.1
2.9
11.1
18.8
14.4
14.4
8.8
9.1
15.9
11.3
3.9
5.8
1.1
-0.1
11.8
6.9
8.0
13.5
10.1
12.3
1.6
5.8
27.9
11.6
17.9
19.0
8.9
14.1
10.7
13.0
10.0
11.5
33.9
15.8
16.8
20.8
10.1
14.3
4.2
11.1
1.5
11.9
1.5
14.0
17.9
12.8
8.8
12.3
8.6
11.2
-4.5
9.2
9.0
4.2
12.2
10.1
8.6
11.6
8.1
10.6
1.5
9.5
6.3
15.6
7.0
8.2
5.3
8.2
6.5
7.8
-2.0
5.5
21.4
-1.8
8.5
9.9
2.5
2.4
3.9
2.8
12.7
11.8
11.2
1.0
8.6
8.1
2.3
9.4
1.0
7.0
-0.4
4.5
3.1
0.9
4.1
3.4
1.3
2.7
1.9
2.5
-4.6
3.3
2.1
1.6
0.0
0.8
0.9
12.2
4.4
10.1
-1.8
1.1
-1.1
35.7
7.0
8.7
5.1
10.8
6.6
9.7
8.3
20.3
-8.5
9.5
9.2
4.8
6.4
8.3
6.0
7.8
35.3
8.4
13.4
14.5
10.4
11.8
7.4
14.5
14.2
8.8
2.2
3.6
3.6
11.6
11.9
7.7
13.0
25.4
9.6
12.4
11.8
3.0
11.5
6.8
7.7
-9.2
1.7
9.3
7.1
7.0
2.8
5.1
6.1
4.9
8.5
8.4
6.3
CIHI 2002
135
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.2—Part 1
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
(percentage distribution of $' 000,000)
Sub-Total
D
1975
44.7
9.2
15.1
6.1
1.9
1.1
9.0
1976
45.2
9.7
14.7
6.2
1.9
1.0
9.1
1977
44.0
10.2
14.8
6.7
1.9
1.1
9.7
1978
43.1
10.8
15.0
7.0
2.0
1.1
10.0
1979
42.3
11.3
14.9
7.2
1.9
1.1
10.2
1980
41.9
11.4
14.7
7.1
1.9
1.1
10.1
10.0
1981
42.0
11.0
14.6
6.9
2.0
1.2
1982
42.6
10.9
14.4
6.7
2.0
1.2
9.9
1983
42.4
11.0
14.8
6.5
2.1
1.2
9.8
1984
41.8
10.6
15.0
6.5
2.3
1.2
10.0
1985
40.8
10.3
15.2
6.8
2.3
1.2
10.4
1986
40.7
9.4
15.4
6.8
2.3
1.3
10.4
1987
40.5
9.3
15.7
6.8
2.3
1.4
10.5
1988
40.0
9.3
15.6
6.9
2.3
1.4
10.6
1989
39.6
9.2
15.2
6.8
2.3
1.5
10.6
1990
39.0
9.4
15.2
6.8
2.3
1.6
10.6
1991
38.7
9.6
15.4
6.7
2.2
1.6
10.6
1992
38.2
9.7
15.0
6.7
2.2
1.7
10.6
1993
37.4
9.5
14.7
6.9
2.2
1.7
10.8
1994
35.9
9.5
14.7
7.1
2.3
1.7
11.1
1995
34.6
9.6
14.4
7.4
2.4
1.8
11.6
1996
34.0
9.7
14.4
7.6
2.4
1.8
11.8
1997
33.3
9.6
14.2
7.5
2.8
2.0
12.3
1998
33.0
9.3
14.0
7.5
2.7
1.8
12.1
1999
32.0
9.5
13.6
7.5
2.6
1.9
12.1
2000
2001 f
2002 f
32.1
31.3
31.3
9.4
9.3
9.3
13.3
13.3
13.4
7.4
7.3
7.2
2.6
2.6
2.6
1.9
1.9
1.8
11.9
11.8
11.6
(annual percentage change)
1975
---
---
1976
1.2
5.6
-2.3
1.8
-0.1
-1.6
1.0
1977
-2.8
4.8
0.3
8.3
3.4
1.6
6.5
1978
-1.9
6.0
1.5
4.0
2.6
3.5
3.7
1979
-1.9
4.6
-0.7
3.0
-2.9
5.0
2.0
1980
-1.1
0.5
-1.1
-0.4
-2.6
0.1
-0.7
1981
0.3
-3.6
-1.3
-3.4
5.2
0.9
-1.4
---
---
---
---
---
1982
1.4
-0.5
-1.3
-2.3
1.4
0.5
-1.2
1983
-0.5
0.4
3.3
-2.9
6.0
4.1
-0.3
1984
-1.4
-2.9
1.3
0.0
7.4
1.8
1.8
1985
-2.3
-3.2
0.9
4.2
3.0
1.2
3.5
1986
-0.3
-8.4
1.5
0.4
-0.5
4.1
0.6
1987
-0.5
-1.9
1.9
0.3
-0.6
4.6
0.6
1988
-1.2
0.5
-0.7
0.1
1.1
3.5
0.8
1989
-1.0
-1.4
-2.7
-0.7
-0.1
5.8
0.3
1990
-1.5
2.8
-0.1
-0.4
-1.0
5.4
0.3
1991
-0.8
1.6
1.6
-0.6
-2.6
4.2
-0.3
1992
-1.4
1.6
-2.8
-0.3
-1.8
2.7
-0.2
1993
-2.1
-2.3
-2.0
2.5
0.9
1.6
2.0
1994
-4.0
-0.4
0.0
3.5
3.7
0.3
3.1
1995
-3.5
1.7
-2.1
3.8
4.1
3.3
3.8
1996
-1.6
0.8
0.3
2.3
2.2
2.3
2.3
1997
-2.1
-1.5
-1.1
-0.9
13.8
9.8
3.8
1998
-1.2
-2.2
-1.5
0.0
-2.3
-7.1
-1.6
1999
-2.9
1.9
-2.8
0.5
-4.0
5.2
0.2
2000
2001 f
2002 f
0.3
-2.3
0.0
-1.4
-1.3
0.1
-2.0
-0.5
0.8
-2.0
-1.4
-1.8
1.1
-0.5
-0.8
-3.2
-0.7
-1.6
-1.5
-1.1
-1.5
f - Forecast
CIHI 2002
136
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.2—Part 2
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
E
Capital Public Health &
Administration
Pre-payment
Administration
Other Health Spending
Health
Other
Research
F
G
(percentage distribution of $' 000,000)
Sub-Total
Grand
Total
H
A+B+C+D
+E+F+G+H
100.0
6.3
2.5
8.8
4.4
4.2
1.7
0.8
2.1
4.6
6.3
2.2
8.5
3.9
4.5
1.5
0.8
2.1
4.3
100.0
6.4
2.1
8.5
3.6
4.7
1.6
0.8
2.2
4.6
100.0
6.1
2.3
8.4
3.9
4.2
1.5
0.9
2.1
4.5
100.0
6.0
2.6
8.6
3.8
4.2
1.5
0.9
2.2
4.6
100.0
5.8
2.6
8.4
4.4
4.3
1.4
0.9
2.4
4.8
100.0
6.4
2.5
8.9
4.2
4.3
1.6
0.9
2.7
5.2
100.0
100.0
6.2
2.3
8.6
4.5
4.3
1.3
0.8
2.7
4.8
6.2
2.5
8.7
4.2
4.2
1.3
0.9
2.8
4.9
100.0
6.1
2.9
9.0
4.1
4.3
1.4
0.9
2.8
5.1
100.0
100.0
6.4
3.1
9.5
4.1
4.5
1.3
1.0
2.9
5.2
7.0
3.2
10.2
4.2
4.2
1.3
1.1
3.1
5.4
100.0
7.0
3.5
10.5
4.0
4.2
1.2
1.0
3.2
5.4
100.0
7.3
3.5
10.8
3.7
4.0
1.4
1.0
3.4
5.9
100.0
7.6
3.5
11.1
3.7
4.1
1.8
1.0
3.7
6.5
100.0
8.0
3.4
11.4
3.5
4.2
1.6
1.1
4.0
6.7
100.0
8.2
3.4
11.6
3.1
4.2
1.6
1.1
4.1
6.8
100.0
100.0
8.7
3.5
12.2
2.9
4.4
1.7
1.2
4.2
7.0
9.2
3.6
12.8
2.8
4.5
2.0
1.1
4.4
7.5
100.0
9.2
3.7
12.9
3.1
5.0
2.1
1.1
4.7
7.9
100.0
10.0
3.6
13.6
3.1
5.1
2.2
1.1
4.8
8.1
100.0
10.2
3.7
13.9
2.9
5.2
2.2
1.1
4.8
8.1
100.0
10.9
3.7
14.5
2.7
5.0
2.1
1.4
4.8
8.3
100.0
11.3
3.7
15.0
2.7
5.7
1.8
1.5
5.0
8.2
100.0
11.4
3.6
15.0
3.5
5.7
1.9
1.6
5.1
8.6
100.0
12.0
12.7
13.0
3.4
3.3
3.2
15.4
15.9
16.2
3.6
4.2
4.3
6.0
6.1
5.9
1.9
1.9
1.9
1.3
1.2
1.3
5.0
5.0
4.8
8.3
8.1
8.0
100.0
100.0
100.0
(annual percentage change)
---
---
---
---
---
---
-0.6
-10.2
-3.4
-11.9
6.3
-12.8
-2.3
-0.4
-5.4
---
1.6
-6.6
-0.6
-5.8
3.9
6.1
11.4
5.0
6.5
---
-3.8
9.3
-0.5
7.7
-10.4
-6.2
4.9
-2.8
-2.6
---
-1.3
12.6
2.4
-3.7
0.9
-0.7
2.1
4.9
2.5
---
-4.0
1.7
-2.3
17.5
1.1
-4.6
0.5
9.2
3.0
---
9.7
-5.2
5.0
-4.8
-0.3
11.3
-3.0
11.7
8.8
---
-2.0
-6.7
-3.3
7.2
1.9
-16.5
-4.8
-0.6
-6.2
---
-1.0
6.9
1.1
-6.9
-2.7
-3.8
4.0
3.0
1.3
---
-0.8
15.9
4.0
-3.0
2.7
11.1
5.0
0.8
4.3
---
5.1
7.7
5.9
1.2
3.7
-9.1
4.8
5.0
1.0
---
8.1
4.1
6.8
0.3
-5.4
2.1
9.3
5.2
5.2
---
1.1
7.4
3.1
-3.8
-2.0
-6.4
-7.5
3.6
-1.0
---
4.2
1.1
3.2
-6.7
-2.8
17.4
2.5
8.2
9.3
---
3.6
0.5
2.6
0.0
1.3
21.7
5.2
6.1
9.8
---
5.0
-4.2
2.1
-6.7
2.8
-6.7
4.8
8.4
3.7
---
3.3
0.0
2.3
-12.1
0.5
0.3
-4.1
3.3
1.4
---
5.9
2.7
5.0
-3.6
4.0
0.9
9.7
1.6
2.7
---
5.6
3.9
5.1
-4.4
2.9
18.5
-4.2
5.9
7.2
---
0.1
1.6
0.5
10.2
9.3
8.8
-1.2
6.2
5.8
---
8.0
-0.3
5.7
-1.7
3.2
1.8
-0.4
2.7
2.0
---
1.8
1.0
1.6
-5.4
2.4
1.2
0.7
-0.8
-0.1
---
6.8
-0.6
4.8
-6.5
-3.8
-5.9
29.2
1.8
3.4
---
4.1
0.1
3.1
1.8
13.1
-14.0
2.8
2.5
-1.5
---
0.9
-1.2
0.4
26.0
0.9
5.6
6.6
2.8
4.1
---
5.6
5.4
2.4
-5.8
-4.5
-2.5
2.8
3.2
1.4
4.2
15.7
3.1
3.6
3.2
-3.1
2.8
-1.5
1.3
-16.3
-6.2
2.9
-1.3
-1.3
-3.2
-3.1
-2.1
-1.2
-------
---
---
---
---
CIHI 2002
137
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.3—Part 1
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' per capita)
1975
235.71
48.58
79.50
31.98
9.77
5.55
47.30
1976
271.10
58.33
88.32
36.99
11.09
6.20
54.29
1977
286.26
66.42
96.28
43.54
12.47
6.85
62.86
1978
307.99
77.21
107.11
49.63
14.02
7.78
71.43
1979
335.24
89.64
118.05
56.70
15.11
9.06
80.87
1980
380.72
103.45
134.09
64.87
16.90
10.42
92.18
1981
444.37
116.12
154.10
72.91
20.69
12.24
105.84
1982
521.20
133.64
176.01
82.43
24.28
14.23
120.93
1983
568.32
146.96
199.18
87.66
28.19
16.23
132.07
1984
599.19
152.58
215.79
93.73
32.38
17.66
143.77
1985
629.20
158.78
233.94
104.90
35.83
19.21
159.93
1986
675.74
156.59
255.73
113.39
38.40
21.53
173.32
1987
716.49
163.67
277.61
121.12
40.66
23.98
185.77
1988
761.25
176.83
296.38
130.38
44.19
26.69
201.26
1989
814.93
188.42
311.78
140.02
47.73
30.54
218.29
1990
859.90
207.51
333.82
149.42
50.64
34.51
234.56
1991
915.49
226.35
364.25
159.38
52.97
38.59
250.94
1992
939.28
239.18
368.39
165.29
54.09
41.24
260.62
1993
931.59
236.73
365.95
171.65
55.29
42.46
269.40
1994
903.93
238.33
369.78
179.65
57.96
43.06
280.68
1995
873.65
242.91
362.55
186.86
60.45
44.55
291.86
1996
858.04
244.38
362.76
190.87
61.68
45.48
298.03
1997
873.79
250.26
372.90
196.64
72.97
51.92
321.53
1998
911.15
258.14
387.53
207.59
75.22
50.91
333.72
1999
941.29
280.03
400.83
222.03
76.89
57.00
355.92
2000
1,014.76
296.81
422.19
233.97
83.59
59.29
376.84
2001 f
1,063.18
314.33
450.56
247.56
89.19
63.15
399.90
2002 f
1,119.23
331.05
477.82
255.83
93.10
65.39
414.32
(annual percentage change)
1975
---
---
---
---
---
---
---
1976
15.0
20.1
11.1
15.7
13.5
11.8
14.8
1977
5.6
13.9
9.0
17.7
12.4
10.4
15.8
1978
7.6
16.2
11.2
14.0
12.4
13.5
13.6
1979
8.8
16.1
10.2
14.2
7.8
16.5
13.2
1980
13.6
15.4
13.6
14.4
11.8
15.0
14.0
1981
16.7
12.2
14.9
12.4
22.4
17.5
14.8
14.3
1982
17.3
15.1
14.2
13.1
17.3
16.3
1983
9.0
10.0
13.2
6.3
16.1
14.1
9.2
1984
5.4
3.8
8.3
6.9
14.9
8.8
8.9
11.2
1985
5.0
4.1
8.4
11.9
10.6
8.8
1986
7.4
-1.4
9.3
8.1
7.2
12.1
8.4
1987
6.0
4.5
8.6
6.8
5.9
11.4
7.2
1988
6.2
8.0
6.8
7.6
8.7
11.3
8.3
1989
7.1
6.6
5.2
7.4
8.0
14.4
8.5
1990
5.5
10.1
7.1
6.7
6.1
13.0
7.5
1991
6.5
9.1
9.1
6.7
4.6
11.8
7.0
1992
2.6
5.7
1.1
3.7
2.1
6.9
3.9
1993
-0.8
-1.0
-0.7
3.9
2.2
3.0
3.4
1994
-3.0
0.7
1.0
4.7
4.8
1.4
4.2
1995
-3.3
1.9
-2.0
4.0
4.3
3.5
4.0
1996
-1.8
0.6
0.1
2.1
2.0
2.1
2.1
1997
1.8
2.4
2.8
3.0
18.3
14.2
7.9
1998
4.3
3.1
3.9
5.6
3.1
-1.9
3.8
1999
3.3
8.5
3.4
7.0
2.2
11.9
6.7
2000
7.8
6.0
5.3
5.4
8.7
4.0
5.9
2001 f
4.8
5.9
6.7
5.8
6.7
6.5
6.1
2002 f
5.3
5.3
6.1
3.3
4.4
3.6
f - Forecast
3.6
CIHI 2002
138
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.1.3—Part 2
Total Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' per capita)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
33.30
13.21
46.50
23.16
22.25
9.15
4.10
10.94
24.19
527.20
37.61
13.48
51.08
23.20
26.88
9.07
4.55
12.38
26.00
599.20
41.52
13.68
55.19
23.76
30.36
10.46
5.51
14.12
30.09
651.23
43.78
16.39
60.17
28.05
29.82
10.76
6.33
15.05
32.14
713.92
47.92
20.47
68.40
29.96
33.39
11.85
7.17
17.52
36.54
792.08
52.83
23.91
76.75
40.41
38.77
12.98
8.28
21.96
43.22
909.60
67.44
26.39
93.83
44.77
45.01
16.81
9.35
28.56
54.73
1,058.76
76.48
28.47
104.94
55.53
53.05
16.23
10.30
32.85
59.39
1,224.70
82.93
33.34
116.28
56.63
56.58
17.11
11.74
37.06
65.92
1,341.94
87.95
41.34
129.29
58.74
62.14
20.34
13.19
39.96
73.49
1,434.99
1,541.84
99.28
47.82
147.10
63.90
69.22
19.87
14.85
45.06
79.78
115.63
53.60
169.23
69.02
70.52
21.85
17.48
51.03
90.36
1,660.53
124.50
61.31
185.82
70.77
73.60
21.80
17.23
56.32
95.34
1,769.08
139.44
66.61
206.05
70.96
76.86
27.52
18.98
65.51
112.01
1,901.60
156.23
72.40
228.63
76.70
84.19
36.20
21.59
75.12
132.90
2,055.85
175.87
74.32
250.19
76.66
92.78
36.19
24.24
87.24
147.67
2,203.10
195.09
79.79
274.88
72.33
100.11
38.98
24.95
96.74
160.67
2,365.02
214.99
85.21
300.21
72.52
108.30
40.92
28.48
102.26
171.67
2,460.16
230.06
89.75
319.81
70.27
112.93
49.13
27.64
109.72
186.49
2,493.16
232.85
92.18
325.03
78.28
124.81
54.02
27.60
117.74
199.36
2,520.19
252.06
92.10
344.17
77.10
129.00
55.11
27.54
121.18
203.83
2,525.07
256.21
92.88
349.09
72.80
131.85
55.67
27.67
119.94
203.28
2,520.22
284.50
95.96
380.46
70.76
131.92
54.47
37.16
127.00
218.63
2,620.26
312.46
101.39
413.85
75.98
157.39
49.40
40.33
137.43
227.16
2,764.92
335.63
106.60
442.23
101.89
169.11
55.52
45.78
150.40
251.70
2,942.99
380.90
107.91
488.81
114.10
188.26
61.34
41.18
159.62
262.14
3,163.93
430.62
110.61
541.23
141.59
208.39
64.83
41.44
169.06
275.33
3,394.51
463.90
113.45
577.35
153.63
212.53
69.12
44.86
172.16
286.14
3,572.07
(annual percentage change)
---
---
---
---
---
0.2
20.8
-0.9
11.1
13.2
7.5
8.0
2.4
12.9
15.3
21.1
14.1
15.7
8.7
9.0
18.1
-1.8
2.8
15.0
6.5
6.8
9.6
24.9
13.7
6.8
12.0
10.1
13.2
16.4
13.7
10.9
10.2
16.8
12.2
34.9
16.1
9.6
15.4
25.4
18.3
14.8
27.7
10.3
22.3
10.8
16.1
29.5
13.0
30.0
26.6
16.4
13.4
7.9
11.8
24.0
17.9
-3.4
10.2
15.0
8.5
15.7
8.4
17.1
10.8
2.0
6.6
5.4
14.0
12.8
11.0
9.6
6.0
24.0
11.2
3.7
9.8
18.8
12.3
7.8
11.5
6.9
12.9
15.7
13.8
8.8
11.4
-2.3
12.6
12.8
8.6
7.4
16.5
12.1
15.0
8.0
1.9
10.0
17.7
13.2
13.3
7.7
7.7
14.4
9.8
2.5
4.4
-0.3
-1.4
10.4
5.5
6.5
12.0
8.6
10.9
0.3
4.4
26.2
10.2
16.3
17.5
7.5
12.0
8.7
11.0
8.1
9.5
31.6
13.7
14.7
18.7
8.1
12.9
---
---
2.1
9.8
10.4
1.5
5.5
19.9
9.5
---
---
--13.7
12.6
2.6
9.4
0.0
10.2
0.0
12.3
16.1
11.1
7.2
10.9
7.4
9.9
-5.7
7.9
7.7
2.9
10.9
8.8
7.3
10.2
6.8
9.2
0.3
8.2
5.0
14.2
5.7
6.8
4.0
7.0
5.3
6.5
-3.1
4.3
20.1
-3.0
7.3
8.6
1.3
1.2
2.7
1.6
11.4
10.5
10.0
-0.1
7.3
6.9
1.1
8.3
-0.1
5.9
-1.5
3.4
2.0
-0.2
2.9
2.2
0.2
1.6
0.8
1.4
-5.6
2.2
1.0
0.5
-1.0
-0.3
-0.2
11.0
3.3
9.0
-2.8
0.1
-2.2
34.3
5.9
7.6
4.0
9.8
5.7
8.8
7.4
19.3
-9.3
8.5
8.2
3.9
5.5
7.4
5.1
6.9
34.1
7.4
12.4
13.5
9.4
10.8
6.4
13.5
1.2
10.5
12.0
11.3
10.5
-10.0
6.1
4.1
7.5
13.1
2.5
10.7
24.1
10.7
5.7
0.6
5.9
5.0
7.3
7.7
2.6
6.7
8.5
2.0
6.6
8.3
1.8
3.9
5.2
CIHI 2002
139
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.1—Part 1
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' 000,000)
1975
318.1
328.4
26.8
685.3
190.3
81.7
957.2
1976
379.6
369.5
29.5
799.3
219.4
91.6
1,110.3
1977
420.1
401.8
32.3
950.9
251.0
102.0
1,303.9
1978
520.1
484.3
38.3
1,087.3
284.0
110.8
1,482.1
1979
626.5
590.3
52.6
1,230.7
307.8
130.3
1,668.8
1980
749.2
718.2
51.5
1,397.0
347.1
150.5
1,894.6
1981
903.4
743.2
49.7
1,533.4
434.9
177.0
2,145.2
1982
1,090.8
853.4
67.7
1,802.7
518.6
214.3
2,535.7
1983
1,243.1
947.2
79.4
1,965.1
609.3
247.7
2,822.1
1984
1,408.5
992.3
81.3
2,135.5
711.7
271.2
3,118.4
1985
1,522.6
1,039.4
83.6
2,435.8
795.5
281.8
3,513.0
1986
1,700.1
1,104.9
76.9
2,672.5
856.2
301.3
3,829.9
1987
1,796.9
1,197.1
76.6
2,917.3
918.3
358.0
4,193.6
1988
1,903.1
1,270.4
80.0
3,182.6
1,003.4
419.2
4,605.3
1989
2,001.1
1,312.8
84.5
3,470.4
1,096.7
491.7
5,058.8
1990
2,240.3
1,581.4
88.6
3,756.8
1,177.3
561.4
5,495.5
1991
2,421.4
1,768.3
91.9
4,061.8
1,237.1
618.7
5,917.5
1992
2,537.8
1,889.9
95.2
4,272.8
1,295.4
677.6
6,245.8
1993
2,670.0
2,012.9
98.8
4,500.9
1,376.0
731.1
6,607.9
1994
2,660.6
2,092.0
103.6
4,781.2
1,479.0
796.0
7,056.2
1995
2,384.1
2,112.6
110.1
5,060.2
1,581.3
853.0
7,494.5
1996
2,315.8
2,105.3
121.7
5,274.1
1,634.9
898.5
7,807.4
1997
2,427.6
2,131.4
123.8
5,514.8
1,974.7
1,084.2
8,573.7
1998
2,259.9
2,183.0
146.1
5,909.1
2,073.5
1,042.3
9,024.9
1999
2,512.9
2,422.1
156.0
6,377.1
2,129.8
1,198.6
9,705.5
2000
2,712.5
2,512.0
178.6
6,779.9
2,345.9
1,232.9
10,358.6
2001 f
2,947.7
2,625.9
193.4
7,252.9
2,539.7
1,358.7
11,151.3
2002 f
3,187.6
2,698.6
206.0
7,612.1
2,704.2
1,465.8
11,782.1
(annual percentage change)
1975
---
---
---
---
---
---
---
1976
19.3
12.5
10.3
16.6
15.3
12.1
16.0
1977
10.7
8.7
9.4
19.0
14.4
11.4
17.4
1978
23.8
20.5
18.7
14.3
13.2
8.6
13.7
1979
20.5
21.9
37.1
13.2
8.3
17.6
12.6
1980
19.6
21.7
-2.0
13.5
12.8
15.5
13.5
1981
20.6
3.5
-3.5
9.8
25.3
17.6
13.2
1982
20.8
14.8
36.1
17.6
19.3
21.1
18.2
1983
14.0
11.0
17.3
9.0
17.5
15.6
11.3
1984
13.3
4.8
2.4
8.7
16.8
9.5
10.5
1985
8.1
4.8
2.9
14.1
11.8
3.9
12.7
1986
11.7
6.3
-8.0
9.7
7.6
6.9
9.0
1987
5.7
8.3
-0.4
9.2
7.3
18.8
9.5
1988
5.9
6.1
4.4
9.1
9.3
17.1
9.8
1989
5.2
3.3
5.6
9.0
9.3
17.3
9.8
1990
12.0
20.5
4.9
8.3
7.4
14.2
8.6
1991
8.1
11.8
3.8
8.1
5.1
10.2
7.7
1992
4.8
6.9
3.6
5.2
4.7
9.5
5.5
1993
5.2
6.5
3.8
5.3
6.2
7.9
5.8
1994
-0.4
3.9
4.8
6.2
7.5
8.9
6.8
1995
-10.4
1.0
6.3
5.8
6.9
7.2
6.2
1996
-2.9
-0.3
10.5
4.2
3.4
5.3
4.2
1997
4.8
1.2
1.8
4.6
20.8
20.7
9.8
1998
-6.9
2.4
18.0
7.2
5.0
-3.9
5.3
1999
11.2
11.0
6.8
7.9
2.7
15.0
7.5
7.9
8.7
8.1
3.7
4.5
2.8
14.5
8.3
6.6
6.3
7.0
5.0
10.1
8.3
6.5
2.9
10.2
7.9
6.7
7.7
5.7
2000
2001 f
2002 f
f - Forecast
CIHI 2002
140
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.1—Part 2
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' 000,000)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
613.1
305.6
918.7
159.6
---
72.2
23.4
94.7
190.4
2,899.2
667.6
316.0
983.6
177.1
---
62.0
29.5
91.4
182.9
3,232.6
721.4
324.5
1,045.9
178.3
---
90.2
36.4
96.6
223.1
3,605.4
724.7
392.8
1,117.6
217.4
---
86.2
43.2
77.1
206.4
4,066.3
776.5
495.5
1,272.0
177.3
---
100.1
50.3
79.5
229.9
4,617.4
833.3
586.3
1,419.6
355.4
---
117.1
63.0
87.8
267.9
5,456.5
1,110.2
655.0
1,765.2
379.3
---
186.5
66.4
95.2
348.1
6,334.1
1,240.5
715.0
1,955.5
489.1
---
146.6
73.8
99.7
320.1
7,312.3
1,289.8
845.9
2,135.6
371.4
---
172.7
82.1
105.0
359.9
7,958.6
1,312.7
1,058.6
2,371.3
364.3
---
250.3
91.2
108.6
450.2
8,786.3
1,447.7
1,235.9
2,683.6
414.4
---
269.2
102.8
118.2
490.3
9,746.9
1,698.8
1,399.0
3,097.9
449.9
---
296.4
119.7
133.0
549.1
10,808.7
1,800.4
1,621.7
3,422.2
480.7
---
280.4
136.1
149.9
566.5
11,733.5
2,034.0
1,784.9
3,818.9
351.0
---
425.3
164.1
177.4
766.8
12,795.4
2,292.0
1,975.6
4,267.7
390.4
---
660.2
196.1
212.9
1,069.1
14,184.3
2,593.9
2,058.7
4,652.5
383.4
---
665.4
226.2
243.8
1,135.4
15,577.1
2,861.9
2,236.6
5,098.5
341.7
---
746.8
249.8
270.9
1,267.5
16,906.9
3,192.3
2,418.1
5,610.4
363.1
---
805.0
265.5
299.3
1,369.8
18,112.0
3,558.7
2,576.0
6,134.7
366.7
---
1,060.0
275.0
351.4
1,686.5
19,577.5
3,673.3
2,676.6
6,349.9
329.6
---
1,226.4
289.9
375.3
1,891.5
20,483.5
4,033.8
2,703.6
6,737.3
439.1
---
1,274.1
315.2
431.2
2,020.5
21,298.3
4,273.3
2,756.0
7,029.3
474.0
---
1,309.1
332.1
409.4
2,050.5
21,904.0
23,550.9
4,933.2
2,877.5
7,810.7
364.3
---
1,291.6
358.9
468.9
2,119.4
5,443.8
3,067.0
8,510.8
418.8
---
1,111.3
427.8
489.5
2,028.6
24,572.3
5,688.5
3,252.3
8,940.7
528.8
---
1,299.7
449.2
569.3
2,318.2
26,584.2
28,442.5
6,426.9
3,322.6
9,749.5
409.5
---
1,475.2
449.6
596.9
2,521.7
7,318.9
3,441.1
10,760.0
481.2
---
1,578.5
471.9
645.5
2,695.9
30,855.3
8,011.0
3,564.0
11,574.9
511.2
---
1,725.0
487.4
686.7
2,899.0
32,859.4
---
---
---
---
26.0
-3.6
-3.9
11.5
(annual percentage change)
---
---
---
---
11.0
---
-14.1
0.7
---
45.4
23.3
5.7
22.0
11.5
21.9
---
-4.4
18.8
-20.2
-7.5
12.8
-18.4
---
16.2
16.4
3.1
11.3
13.6
100.4
---
17.0
25.4
10.4
16.5
18.2
6.7
---
59.2
5.4
8.5
29.9
16.1
10.8
29.0
---
-21.4
11.1
4.7
-8.1
15.4
18.3
9.2
-24.1
---
17.8
11.4
5.4
12.4
8.8
25.2
11.0
-1.9
---
44.9
11.1
3.4
25.1
10.4
10.3
16.7
13.2
13.8
---
7.6
12.7
8.8
8.9
10.9
17.3
13.2
15.4
8.6
---
10.1
16.4
12.5
12.0
10.9
6.0
15.9
10.5
6.9
---
-5.4
13.7
12.7
3.2
8.6
13.0
10.1
11.6
-27.0
---
51.7
20.6
18.3
35.4
9.1
12.7
10.7
11.8
11.2
---
55.2
19.5
20.0
39.4
10.9
13.2
4.2
9.0
-1.8
---
0.8
15.4
14.5
6.2
9.8
10.3
8.6
9.6
-10.9
---
12.2
10.4
11.1
11.6
8.5
11.5
8.1
10.0
6.3
---
7.8
6.3
10.5
8.1
7.1
11.5
6.5
9.3
1.0
---
31.7
3.6
17.4
23.1
8.1
3.2
3.9
3.5
-10.1
---
15.7
5.4
6.8
12.2
4.6
9.8
1.0
6.1
33.2
---
3.9
8.7
14.9
6.8
4.0
5.9
1.9
4.3
7.9
---
2.7
5.4
-5.1
1.5
2.8
15.4
4.4
11.1
-23.1
---
-1.3
8.1
14.5
3.4
7.5
10.4
6.6
9.0
15.0
---
-14.0
19.2
4.4
-4.3
4.3
4.5
6.0
5.1
26.2
---
17.0
5.0
16.3
14.3
8.2
13.0
13.9
9.5
2.2
3.6
3.6
9.0
10.4
7.6
-22.6
17.5
6.2
-------
13.5
7.0
9.3
0.1
5.0
3.3
4.8
8.2
6.4
8.8
6.9
7.5
7.0
8.5
6.5
8.9
---
---
3.4
7.1
8.1
2.7
6.3
0.5
21.1
6.9
7.1
26.2
13.8
7.3
18.3
11.6
33.2
11.7
24.3
11.7
9.2
4.0
1.8
CIHI 2002
141
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.2—Part 1
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Other Professionals
Vision
Other
Care
Services
C
(percentage distribution of $' 000,000)
Sub-Total
Year
A
B
D
1975
11.0
11.3
0.9
23.6
6.6
2.8
33.0
1976
11.7
11.4
0.9
24.7
6.8
2.8
34.3
1977
11.7
11.1
0.9
26.4
7.0
2.8
36.2
1978
12.8
11.9
0.9
26.7
7.0
2.7
36.4
1979
13.6
12.8
1.1
26.7
6.7
2.8
36.1
1980
13.7
13.2
0.9
25.6
6.4
2.8
34.7
1981
14.3
11.7
0.8
24.2
6.9
2.8
33.9
1982
14.9
11.7
0.9
24.7
7.1
2.9
34.7
1983
15.6
11.9
1.0
24.7
7.7
3.1
35.5
1984
16.0
11.3
0.9
24.3
8.1
3.1
35.5
1985
15.6
10.7
0.9
25.0
8.2
2.9
36.0
1986
15.7
10.2
0.7
24.7
7.9
2.8
35.4
1987
15.3
10.2
0.7
24.9
7.8
3.1
35.7
1988
14.9
9.9
0.6
24.9
7.8
3.3
36.0
1989
14.1
9.3
0.6
24.5
7.7
3.5
35.7
1990
14.4
10.2
0.6
24.1
7.6
3.6
35.3
1991
14.3
10.5
0.5
24.0
7.3
3.7
35.0
1992
14.0
10.4
0.5
23.6
7.2
3.7
34.5
1993
13.6
10.3
0.5
23.0
7.0
3.7
33.8
1994
13.0
10.2
0.5
23.3
7.2
3.9
34.4
1995
11.2
9.9
0.5
23.8
7.4
4.0
35.2
1996
10.6
9.6
0.6
24.1
7.5
4.1
35.6
1997
10.3
9.1
0.5
23.4
8.4
4.6
36.4
1998
9.2
8.9
0.6
24.0
8.4
4.2
36.7
1999
9.5
9.1
0.6
24.0
8.0
4.5
36.5
2000
2001 f
2002 f
9.5
9.6
9.7
8.8
8.5
8.2
0.6
0.6
0.6
23.8
23.5
23.2
8.2
8.2
8.2
4.3
4.4
4.5
36.4
36.1
35.9
---
---
(annual percentage change)
1975
---
---
---
---
---
1976
7.0
0.9
-1.1
4.6
3.4
0.5
4.0
1977
-0.8
-2.5
-1.9
6.7
2.5
-0.1
5.3
1978
9.8
6.9
5.3
1.4
0.4
-3.7
0.8
1979
6.1
7.3
20.7
-0.3
-4.6
3.6
-0.8
1980
1.2
2.9
-17.0
-3.9
-4.6
-2.3
-3.9
1981
3.9
-10.9
-16.9
-5.4
7.9
1.3
-2.5
1982
4.6
-0.5
17.9
1.8
3.3
4.9
2.4
1983
4.7
2.0
7.8
0.2
7.9
6.2
2.3
1984
2.6
-5.1
-7.3
-1.6
5.8
-0.8
0.1
1985
-2.6
-5.6
-7.3
2.8
0.8
-6.3
1.6
1986
0.7
-4.1
-17.0
-1.1
-2.9
-3.6
-1.7
1987
-2.6
-0.2
-8.2
0.6
-1.2
9.4
0.9
1988
-2.9
-2.7
-4.3
0.0
0.2
7.4
0.7
1989
-5.1
-6.8
-4.7
-1.6
-1.4
5.8
-0.9
1990
1.9
9.7
-4.5
-1.4
-2.2
4.0
-1.1
1991
-0.4
3.0
-4.4
-0.4
-3.2
1.5
-0.8
1992
-2.2
-0.2
-3.3
-1.8
-2.2
2.2
-1.5
1993
-2.7
-1.5
-4.0
-2.5
-1.7
-0.2
-2.1
1994
-4.8
-0.7
0.2
1.5
2.7
4.1
2.1
1995
-13.8
-2.9
2.2
1.8
2.8
3.1
2.1
1996
-5.6
-3.1
7.4
1.3
0.5
2.4
1.3
1997
-2.5
-5.8
-5.3
-2.7
12.3
12.2
2.1
1998
-10.8
-1.8
13.1
2.7
0.6
-7.9
0.9
1999
2.8
2.6
-1.3
-0.2
-5.1
6.3
-0.6
2000
2001 f
2002 f
0.9
0.2
1.5
-3.1
-3.6
-3.5
7.1
-0.2
0.1
-0.6
-1.4
-1.4
3.0
-0.2
0.0
-3.9
1.6
1.3
-0.2
-0.8
-0.8
f - Forecast
CIHI 2002
142
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.2—Part 2
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
E
Capital Public Health &
Administration
Pre-payment
Administration
Other Health Spending
Health
Other
Research
F
G
(percentage distribution of $' 000,000)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
21.1
10.5
31.7
5.5
---
2.5
0.8
3.3
6.6
100.0
20.7
9.8
30.4
5.5
---
1.9
0.9
2.8
5.7
100.0
20.0
9.0
29.0
4.9
---
2.5
1.0
2.7
6.2
100.0
17.8
9.7
27.5
5.3
---
2.1
1.1
1.9
5.1
100.0
16.8
10.7
27.5
3.8
---
2.2
1.1
1.7
5.0
100.0
15.3
10.7
26.0
6.5
---
2.1
1.2
1.6
4.9
100.0
17.5
10.3
27.9
6.0
---
2.9
1.0
1.5
5.5
100.0
17.0
9.8
26.7
6.7
---
2.0
1.0
1.4
4.4
100.0
16.2
10.6
26.8
4.7
---
2.2
1.0
1.3
4.5
100.0
14.9
12.0
27.0
4.1
---
2.8
1.0
1.2
5.1
100.0
14.9
12.7
27.5
4.3
---
2.8
1.1
1.2
5.0
100.0
15.7
12.9
28.7
4.2
---
2.7
1.1
1.2
5.1
100.0
15.3
13.8
29.2
4.1
---
2.4
1.2
1.3
4.8
100.0
15.9
13.9
29.8
2.7
---
3.3
1.3
1.4
6.0
100.0
16.2
13.9
30.1
2.8
---
4.7
1.4
1.5
7.5
100.0
16.7
13.2
29.9
2.5
---
4.3
1.5
1.6
7.3
100.0
16.9
13.2
30.2
2.0
---
4.4
1.5
1.6
7.5
100.0
17.6
13.4
31.0
2.0
---
4.4
1.5
1.7
7.6
100.0
18.2
13.2
31.3
1.9
---
5.4
1.4
1.8
8.6
100.0
17.9
13.1
31.0
1.6
---
6.0
1.4
1.8
9.2
100.0
18.9
12.7
31.6
2.1
---
6.0
1.5
2.0
9.5
100.0
19.5
12.6
32.1
2.2
---
6.0
1.5
1.9
9.4
100.0
20.9
12.2
33.2
1.5
---
5.5
1.5
2.0
9.0
100.0
22.2
12.5
34.6
1.7
---
4.5
1.7
2.0
8.3
100.0
21.4
12.2
33.6
2.0
---
4.9
1.7
2.1
8.7
100.0
22.6
23.7
24.4
11.7
11.2
10.8
34.3
34.9
35.2
1.4
1.6
1.6
-------
5.2
5.1
5.2
1.6
1.5
1.5
2.1
2.1
2.1
8.9
8.7
8.8
100.0
100.0
100.0
(annual percentage change)
---
---
---
---
---
---
---
---
---
-2.4
-7.3
-4.0
-0.5
---
-23.0
13.0
---
-13.5
-13.8
---
-3.1
-7.9
-4.7
-9.8
---
30.4
10.5
-5.2
9.4
---
-10.9
7.3
-5.3
8.1
---
-15.3
5.3
-29.2
-18.0
---
-5.7
11.1
0.2
-28.2
---
2.3
2.5
-9.2
-1.9
---
-9.2
0.1
-5.6
69.6
---
-1.0
6.1
-6.6
-1.4
---
14.8
-3.8
7.1
-8.1
---
37.2
-9.2
-6.5
11.9
---
-3.2
-5.4
-4.0
11.7
---
-31.9
-3.8
-9.3
-20.4
---
-4.5
8.7
0.3
-30.2
---
8.2
2.3
-3.2
3.3
---
-7.8
13.4
0.6
-11.2
---
31.3
0.6
-6.3
13.3
---
-0.6
5.2
2.0
2.5
---
-3.0
1.6
-1.9
-1.8
---
5.8
2.1
4.1
-2.1
---
-0.7
4.9
1.5
1.0
---
-2.4
6.8
1.8
-1.6
---
-12.8
4.8
3.8
-5.0
---
3.6
0.9
2.3
-33.0
---
39.1
10.6
8.5
24.1
---
1.7
-0.2
0.8
0.3
---
40.0
7.8
8.3
25.8
---
3.0
-5.1
-0.7
-10.6
---
-8.2
5.1
4.3
-3.3
---
1.7
0.1
1.0
-17.9
---
3.4
1.7
2.4
2.9
---
4.1
0.9
2.7
-0.8
---
0.6
-0.8
3.2
0.9
---
3.1
-1.4
1.2
-6.6
---
21.8
-4.2
8.6
13.9
---
-1.3
-0.7
-1.1
-14.1
---
10.6
0.7
2.1
7.2
---
5.6
-2.9
2.0
28.1
---
-0.1
4.6
10.5
2.7
---
3.0
-0.9
1.4
5.0
---
-0.1
2.4
-7.7
-1.3
---
7.4
-2.9
3.3
-28.5
---
-8.2
0.5
6.5
-3.9
---
5.8
2.2
4.4
10.2
---
-17.5
14.3
0.1
-8.3
---
-3.4
-2.0
-2.9
16.7
---
8.1
-2.9
7.5
5.6
---
5.6
5.0
2.8
-4.5
-4.5
-2.7
1.9
1.7
1.0
-27.6
8.3
-0.2
-------
6.1
-1.4
2.6
-6.5
-3.3
-3.0
-2.0
-0.3
-0.1
1.7
-1.5
1.0
------CIHI 2002
143
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.3—Part 1
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' per capita)
1975
13.74
14.19
1.16
29.61
8.22
3.53
41.36
1976
16.19
15.76
1.26
34.09
9.36
3.90
47.35
1977
17.71
16.93
1.36
40.08
10.58
4.30
54.96
1978
21.70
20.21
1.60
45.37
11.85
4.62
61.85
1979
25.89
24.39
2.17
50.85
12.72
5.38
68.95
1980
30.56
29.29
2.10
56.98
14.16
6.14
77.28
1981
36.40
29.94
2.00
61.78
17.52
7.13
86.43
1982
43.43
33.98
2.69
71.77
20.65
8.53
100.95
1983
49.00
37.34
3.13
77.47
24.02
9.76
111.25
1984
55.00
38.75
3.17
83.40
27.79
10.59
121.78
1985
58.92
40.22
3.24
94.26
30.78
10.90
135.94
1986
65.14
42.33
2.95
102.39
32.80
11.54
146.74
1987
67.94
45.26
2.90
110.30
34.72
13.53
158.55
1988
71.02
47.40
2.98
118.76
37.44
15.64
171.85
1989
73.34
48.11
3.10
127.18
40.19
18.02
185.40
1990
80.88
57.09
3.20
135.62
42.50
20.26
198.39
1991
86.38
63.08
3.28
144.90
44.13
22.07
211.11
1992
89.43
66.60
3.36
150.58
45.65
23.88
220.10
1993
93.02
70.13
3.44
156.81
47.94
25.47
230.22
1994
91.63
72.05
3.57
164.67
50.94
27.41
243.02
1995
81.22
71.97
3.75
172.39
53.87
29.06
255.32
1996
78.05
70.95
4.10
177.75
55.10
30.28
263.13
1997
80.96
71.08
4.13
183.90
65.85
36.16
285.91
1998
74.71
72.17
4.83
195.35
68.55
34.46
298.36
1999
82.37
79.39
5.11
209.02
69.81
39.29
318.12
2000
88.10
81.58
5.80
220.19
76.19
40.04
336.42
2001 f
94.75
84.41
6.22
233.13
81.64
43.67
358.44
2002 f
101.47
85.90
6.56
242.32
86.08
46.66
375.06
(annual percentage change)
1975
---
---
1976
17.8
11.1
---
---
---
---
8.8
15.1
13.8
10.6
14.5
---
1977
9.4
7.5
8.2
17.6
13.0
10.1
16.1
1978
22.6
19.3
17.5
13.2
12.1
7.5
12.5
1979
19.3
20.7
35.8
12.1
7.3
16.5
11.5
1980
18.0
20.1
-3.2
12.1
11.3
14.0
12.1
1981
19.1
2.2
-4.7
8.4
23.7
16.2
11.8
1982
19.3
13.5
34.5
16.2
17.9
19.6
16.8
1983
12.8
9.9
16.2
7.9
16.3
14.4
10.2
1984
12.2
3.8
1.4
7.7
15.7
8.5
9.5
1985
7.1
3.8
1.9
13.0
10.8
3.0
11.6
1986
10.6
5.2
-8.9
8.6
6.6
5.9
7.9
1987
4.3
6.9
-1.7
7.7
5.8
17.2
8.0
1988
4.5
4.7
3.0
7.7
7.9
15.6
8.4
1989
3.3
1.5
3.7
7.1
7.3
15.2
7.9
1990
10.3
18.7
3.3
6.6
5.7
12.5
7.0
1991
6.8
10.5
2.6
6.8
3.8
8.9
6.4
1992
3.5
5.6
2.3
3.9
3.4
8.2
4.3
1993
4.0
5.3
2.6
4.1
5.0
6.7
4.6
1994
-1.5
2.7
3.6
5.0
6.3
7.6
5.6
1995
-11.4
-0.1
5.1
4.7
5.8
6.0
5.1
1996
-3.9
-1.4
9.3
3.1
2.3
4.2
3.1
1997
3.7
0.2
0.7
3.5
19.5
19.4
8.7
1998
-7.7
1.5
16.9
6.2
4.1
-4.7
4.4
1999
10.2
10.0
5.9
7.0
1.8
14.0
6.6
2000
7.0
2.8
13.5
5.3
9.1
1.9
5.8
2001 f
7.6
3.5
7.1
5.9
7.2
9.1
6.5
2002 f
7.1
1.8
5.5
3.9
5.4
6.8
4.6
f - Forecast
CIHI 2002
144
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.2.3—Part 2
Private Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' per capita)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
26.49
13.21
39.70
6.90
---
3.12
1.01
4.09
8.23
125.28
28.47
13.48
41.95
7.55
---
2.64
1.26
3.90
7.80
137.85
30.40
13.68
44.08
7.51
---
3.80
1.53
4.07
9.40
151.96
30.24
16.39
46.63
9.07
---
3.60
1.80
3.22
8.61
169.68
32.08
20.47
52.56
7.33
---
4.14
2.08
3.28
9.50
190.78
33.99
23.91
57.91
14.50
---
4.78
2.57
3.58
10.93
222.57
44.73
26.39
71.12
15.28
---
7.51
2.68
3.84
14.03
255.20
49.39
28.47
77.85
19.47
---
5.84
2.94
3.97
12.74
291.12
50.84
33.34
84.19
14.64
---
6.81
3.24
4.14
14.19
313.74
51.26
41.34
92.60
14.22
---
9.77
3.56
4.24
17.58
343.11
56.02
47.82
103.84
16.03
---
10.42
3.98
4.57
18.97
377.16
65.09
53.60
118.69
17.24
---
11.36
4.58
5.10
21.04
414.12
68.07
61.31
129.38
18.18
---
10.60
5.15
5.67
21.42
443.61
75.90
66.61
142.51
13.10
---
15.87
6.12
6.62
28.61
477.47
84.00
72.40
156.40
14.31
---
24.19
7.19
7.80
39.18
519.84
93.64
74.32
167.96
13.84
---
24.02
8.17
8.80
40.99
562.33
102.10
79.79
181.89
12.19
---
26.64
8.91
9.66
45.22
603.15
112.50
85.21
197.71
12.80
---
28.37
9.36
10.55
48.27
638.27
123.98
89.75
213.73
12.78
---
36.93
9.58
12.24
58.76
682.07
126.51
92.18
218.69
11.35
---
42.24
9.98
12.92
65.14
705.45
137.42
92.10
229.52
14.96
---
43.40
10.74
14.69
68.83
725.57
144.02
92.88
236.90
15.98
---
44.12
11.19
13.80
69.11
738.21
164.51
95.96
260.47
12.15
---
43.07
11.97
15.64
70.68
785.37
179.97
101.39
281.36
13.85
---
36.74
14.14
16.18
67.07
812.35
186.45
106.60
293.05
17.33
---
42.60
14.72
18.66
75.98
871.35
208.73
107.91
316.64
13.30
---
47.91
14.60
19.38
81.90
923.73
235.25
110.61
345.86
15.47
---
50.74
15.17
20.75
86.66
991.80
255.01
113.45
368.46
16.27
---
54.91
15.51
21.86
92.28
1,046.01
---
---
---
---
24.3
-4.8
-5.2
10.0
(annual percentage change)
--7.5
--2.1
--5.7
---
---
9.5
---
-15.2
---
6.8
1.5
5.1
-0.5
---
43.7
21.9
4.4
20.6
10.2
-0.5
19.9
5.8
20.7
---
-5.4
17.6
-21.0
-8.4
11.7
6.1
24.9
12.7
-19.2
---
15.0
15.2
2.1
10.2
12.4
16.7
6.0
16.8
10.2
97.9
---
15.5
23.7
9.0
15.1
31.6
10.3
22.8
5.4
---
57.3
4.1
7.2
28.4
14.7
10.4
7.9
9.5
27.4
---
-22.3
9.8
3.4
-9.1
14.1
2.9
17.1
8.1
-24.8
---
16.6
10.3
4.4
11.3
7.8
0.8
24.0
10.0
-2.8
---
43.5
10.0
2.5
23.9
9.4
9.3
15.7
12.1
12.7
---
6.6
11.7
7.8
7.9
9.9
16.2
12.1
14.3
7.5
---
9.0
15.2
11.4
10.9
9.8
4.6
14.4
9.0
5.4
---
-6.6
12.2
11.2
1.8
7.1
11.5
8.6
10.1
-27.9
---
49.7
19.0
16.8
33.6
7.6
10.7
8.7
9.8
9.2
---
52.5
17.3
17.9
36.9
8.9
11.5
2.6
7.4
-3.3
---
-0.7
13.7
12.8
4.6
8.2
9.0
7.4
8.3
-11.9
---
10.9
9.1
9.8
10.3
7.3
10.2
6.8
8.7
5.0
---
6.5
5.0
9.2
6.8
5.8
10.2
5.3
8.1
-0.2
---
30.2
2.4
16.1
21.7
6.9
2.0
2.7
2.3
-11.1
---
14.4
4.2
5.6
10.9
3.4
8.6
-0.1
5.0
31.8
---
2.8
7.6
13.7
5.7
2.9
4.8
0.8
3.2
6.8
---
1.6
4.2
-6.1
0.4
1.7
14.2
3.3
9.9
-23.9
---
-2.4
6.9
13.3
2.3
6.4
9.4
5.7
8.0
14.0
---
-14.7
18.2
3.5
-5.1
3.4
3.6
5.1
4.2
25.2
---
16.0
4.1
15.3
13.3
7.3
11.9
1.2
8.0
-23.3
---
12.5
-0.8
3.9
7.8
6.0
12.7
2.5
9.2
16.3
---
5.9
3.9
7.0
5.8
7.4
8.4
2.6
6.5
5.2
---
8.2
2.3
5.3
6.5
5.5
CIHI 2002
145
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.1—Part 1
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' 000,000)
1975
5,136.7
795.9
1,813.2
54.8
35.9
46.7
137.4
1976
5,977.6
998.2
2,041.5
68.1
40.6
53.9
162.7
1977
6,371.8
1,174.1
2,252.1
82.0
44.9
60.5
187.4
1978
6,860.5
1,366.0
2,528.3
102.1
51.9
75.5
229.6
1979
7,487.0
1,579.2
2,804.5
141.5
58.0
88.9
288.4
365.4
1980
8,584.5
1,818.0
3,236.0
193.3
67.2
104.9
1981
10,126.2
2,138.9
3,775.1
276.3
78.7
126.7
481.7
1982
12,000.5
2,503.4
4,353.1
267.7
91.1
143.0
501.8
1983
13,173.4
2,780.7
4,973.3
258.5
105.7
164.0
528.2
1984
13,935.3
2,915.0
5,444.6
264.7
117.6
181.0
563.3
1985
14,737.5
3,063.8
5,962.1
275.0
130.4
214.6
620.0
1986
15,937.1
2,982.3
6,597.9
287.2
146.1
260.7
693.9
1987
17,154.2
3,132.1
7,266.2
286.3
157.3
276.4
719.9
1988
18,497.2
3,468.3
7,862.5
311.3
180.8
296.0
788.1
1989
20,235.3
3,828.5
8,422.7
350.3
205.6
341.5
897.4
1990
21,579.6
4,166.8
9,158.6
382.2
225.4
394.5
1,002.1
1991
23,240.6
4,576.6
10,118.3
405.7
247.7
463.0
1,116.4
1992
24,115.7
4,897.2
10,358.3
417.4
239.6
492.6
1,149.6
1993
24,069.5
4,781.9
10,405.0
426.1
211.0
487.7
1,124.7
1994
23,586.0
4,828.1
10,633.3
435.2
204.1
454.3
1,093.6
1995
23,261.0
5,017.7
10,532.0
424.8
193.1
454.9
1,072.8
1996
23,143.9
5,146.0
10,642.1
389.3
195.3
451.0
1,035.5
1997
23,774.8
5,373.3
11,058.4
381.9
213.6
472.6
1,068.1
1998
25,300.9
5,625.3
11,576.3
370.1
201.8
497.7
1,069.6
1999
26,205.2
6,121.5
12,073.0
396.9
216.2
540.2
1,153.3
2000
2001 f
2002 f
28,532.8
30,128.4
31,971.8
6,627.2
7,153.2
7,701.0
12,820.9
13,823.7
14,804.3
424.3
448.7
424.5
227.9
235.1
220.6
592.6
605.8
588.3
1,244.7
1,289.7
1,233.4
(annual percentage change)
1975
---
---
---
---
---
---
---
1976
16.4
25.4
12.6
24.3
13.4
15.4
18.4
1977
6.6
17.6
10.3
20.4
10.4
12.3
15.2
1978
7.7
16.3
12.3
24.5
15.7
24.8
22.5
1979
9.1
15.6
10.9
38.6
11.6
17.7
25.6
1980
14.7
15.1
15.4
36.6
15.9
18.0
26.7
1981
18.0
17.6
16.7
42.9
17.1
20.8
31.8
1982
18.5
17.0
15.3
-3.1
15.8
12.9
4.2
1983
9.8
11.1
14.2
-3.4
16.0
14.7
5.3
1984
5.8
4.8
9.5
2.4
11.2
10.4
6.6
1985
5.8
5.1
9.5
3.9
10.9
18.6
10.1
1986
8.1
-2.7
10.7
4.4
12.0
21.5
11.9
1987
7.6
5.0
10.1
-0.3
7.7
6.0
3.8
1988
7.8
10.7
8.2
8.8
14.9
7.1
9.5
1989
9.4
10.4
7.1
12.5
13.7
15.4
13.9
1990
6.6
8.8
8.7
9.1
9.6
15.5
11.7
1991
7.7
9.8
10.5
6.1
9.9
17.4
11.4
1992
3.8
7.0
2.4
2.9
-3.3
6.4
3.0
1993
-0.2
-2.4
0.5
2.1
-11.9
-1.0
-2.2
1994
-2.0
1.0
2.2
2.1
-3.3
-6.8
-2.8
1995
-1.4
3.9
-1.0
-2.4
-5.4
0.1
-1.9
1996
-0.5
2.6
1.0
-8.4
1.1
-0.8
-3.5
1997
2.7
4.4
3.9
-1.9
9.4
4.8
3.1
1998
6.4
4.7
4.7
-3.1
-5.5
5.3
0.1
1999
3.6
8.8
4.3
7.2
7.1
8.5
7.8
2000
2001 f
2002 f
8.9
5.6
6.1
8.3
7.9
7.7
6.2
7.8
7.1
6.9
5.8
-5.4
5.4
3.2
-6.2
9.7
2.2
-2.9
7.9
3.6
-4.4
f - Forecast
CIHI 2002
146
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.1—Part 2
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' 000,000)
Sub-Total
H
Grand
Total
A+B+C+D
+E+F+G+H
157.5
---
157.5
376.4
514.9
139.6
71.4
158.4
369.3
9,301.4
214.3
---
214.3
367.0
630.4
150.6
77.2
199.0
426.8
10,818.5
263.6
---
263.6
385.4
720.4
158.0
94.3
238.5
490.9
11,845.8
324.5
---
324.5
454.8
714.7
171.6
108.6
283.6
563.8
13,042.1
383.3
---
383.3
547.8
808.1
186.7
123.3
344.5
654.5
14,552.7
461.9
---
461.9
635.3
950.5
201.1
140.0
450.7
791.8
16,843.4
563.7
---
563.7
731.9
1,117.2
230.8
165.7
613.6
1,010.2
19,944.8
680.4
---
680.4
905.7
1,332.6
261.1
185.0
725.5
1,171.6
23,449.1
814.0
---
814.0
1,065.2
1,435.3
261.4
215.8
835.1
1,312.3
26,082.3
939.5
---
939.5
1,139.9
1,591.3
270.5
246.6
914.7
1,431.7
27,960.4
1,117.9
---
1,117.9
1,236.9
1,788.8
244.1
281.0
1,046.4
1,571.5
30,098.4
1,319.2
---
1,319.2
1,351.5
1,840.7
274.0
336.5
1,199.0
1,809.5
32,532.0
1,492.7
---
1,492.7
1,391.1
1,946.8
296.1
319.5
1,339.7
1,955.3
35,058.4
1,702.8
---
1,702.8
1,550.7
2,059.8
312.1
344.5
1,578.3
2,234.8
38,164.3
1,970.9
---
1,970.9
1,702.4
2,297.3
327.5
392.9
1,836.9
2,557.3
41,911.9
2,278.0
---
2,278.0
1,740.3
2,570.1
337.2
445.2
2,172.8
2,955.1
45,450.5
2,606.7
---
2,606.7
1,685.8
2,806.1
345.7
449.6
2,440.9
3,236.2
49,386.7
2,908.5
---
2,908.5
1,694.9
3,073.3
356.2
542.7
2,602.5
3,501.5
51,699.0
3,044.9
---
3,044.9
1,650.2
3,241.5
350.1
518.4
2,797.8
3,666.3
51,984.0
3,087.6
---
3,087.6
1,943.2
3,623.9
342.3
511.6
3,043.3
3,897.2
52,692.8
3,365.3
---
3,365.3
1,824.0
3,786.8
343.5
493.2
3,126.0
3,962.7
52,822.2
3,328.8
---
3,328.8
1,685.9
3,912.4
342.7
489.0
3,149.3
3,981.1
52,875.7
3,598.1
---
3,598.1
1,757.6
3,956.0
341.8
755.5
3,339.5
4,436.8
55,023.2
4,007.5
---
4,007.5
1,879.5
4,760.7
383.1
792.1
3,667.4
4,842.6
59,062.3
4,551.3
---
4,551.3
2,579.8
5,159.4
394.2
947.4
4,019.4
5,360.9
63,204.4
5,301.4
6,077.9
6,561.9
-------
5,301.4
6,077.9
6,561.9
3,103.9
3,923.9
4,314.9
5,796.8
6,483.2
6,676.5
413.5
438.6
446.5
818.4
817.2
921.9
4,317.9
4,614.2
4,721.6
5,549.8
5,869.9
6,089.9
68,977.5
74,749.9
79,353.7
(annual percentage change)
---
---
---
---
---
---
---
---
36.1
---
36.1
-2.5
22.4
--7.9
--8.1
25.6
15.6
16.3
23.0
---
23.0
5.0
14.3
4.9
22.2
19.9
15.0
9.5
23.1
---
23.1
18.0
-0.8
8.6
15.1
18.9
14.9
10.1
18.1
---
18.1
20.4
13.1
8.8
13.6
21.5
16.1
11.6
20.5
---
20.5
16.0
17.6
7.8
13.5
30.8
21.0
15.7
22.0
---
22.0
15.2
17.5
14.8
18.4
36.2
27.6
18.4
20.7
---
20.7
23.7
19.3
13.1
11.6
18.2
16.0
17.6
19.6
---
19.6
17.6
7.7
0.1
16.6
15.1
12.0
11.2
15.4
---
15.4
7.0
10.9
3.5
14.3
9.5
9.1
7.2
19.0
---
19.0
8.5
12.4
-9.7
14.0
14.4
9.8
7.6
18.0
---
18.0
9.3
2.9
12.2
19.8
14.6
15.1
8.1
13.2
---
13.2
2.9
5.8
8.1
-5.0
11.7
8.1
7.8
14.1
---
14.1
11.5
5.8
5.4
7.8
17.8
14.3
8.9
15.7
---
15.7
9.8
11.5
4.9
14.0
16.4
14.4
9.8
15.6
---
15.6
2.2
11.9
3.0
13.3
18.3
15.6
8.4
14.4
---
14.4
-3.1
9.2
2.5
1.0
12.3
9.5
8.7
11.6
---
11.6
0.5
9.5
3.1
20.7
6.6
8.2
4.7
4.7
---
4.7
-2.6
5.5
-1.7
-4.5
7.5
4.7
0.6
1.4
---
1.4
17.8
11.8
-2.2
-1.3
8.8
6.3
1.4
9.0
---
9.0
-6.1
4.5
0.4
-3.6
2.7
1.7
0.2
-1.1
---
-1.1
-7.6
3.3
-0.2
-0.8
0.7
0.5
0.1
8.1
---
8.1
4.3
1.1
-0.3
54.5
6.0
11.4
4.1
11.4
---
11.4
6.9
20.3
12.1
4.8
9.8
9.1
7.3
13.6
---
13.6
37.3
8.4
2.9
19.6
9.6
10.7
7.0
16.5
14.6
8.0
-------
16.5
14.6
8.0
20.3
26.4
10.0
12.4
11.8
3.0
4.9
6.1
1.8
-13.6
-0.2
12.8
7.4
6.9
2.3
3.5
5.8
3.7
9.1
8.4
6.2
CIHI 2002
147
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.2—Part 1
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Other Professionals
Vision
Other
Care
Services
C
(percentage distribution of $' 000,000)
Sub-Total
Year
A
B
D
1975
55.2
8.6
19.5
0.6
0.4
0.5
1.5
1976
55.3
9.2
18.9
0.6
0.4
0.5
1.5
1977
53.8
9.9
19.0
0.7
0.4
0.5
1.6
1978
52.6
10.5
19.4
0.8
0.4
0.6
1.8
1979
51.4
10.9
19.3
1.0
0.4
0.6
2.0
1980
51.0
10.8
19.2
1.1
0.4
0.6
2.2
1981
50.8
10.7
18.9
1.4
0.4
0.6
2.4
1982
51.2
10.7
18.6
1.1
0.4
0.6
2.1
1983
50.5
10.7
19.1
1.0
0.4
0.6
2.0
1984
49.8
10.4
19.5
0.9
0.4
0.6
2.0
1985
49.0
10.2
19.8
0.9
0.4
0.7
2.1
1986
49.0
9.2
20.3
0.9
0.4
0.8
2.1
1987
48.9
8.9
20.7
0.8
0.4
0.8
2.1
1988
48.5
9.1
20.6
0.8
0.5
0.8
2.1
1989
48.3
9.1
20.1
0.8
0.5
0.8
2.1
1990
47.5
9.2
20.2
0.8
0.5
0.9
2.2
1991
47.1
9.3
20.5
0.8
0.5
0.9
2.3
1992
46.6
9.5
20.0
0.8
0.5
1.0
2.2
1993
46.3
9.2
20.0
0.8
0.4
0.9
2.2
1994
44.8
9.2
20.2
0.8
0.4
0.9
2.1
1995
44.0
9.5
19.9
0.8
0.4
0.9
2.0
1996
43.8
9.7
20.1
0.7
0.4
0.9
2.0
1997
43.2
9.8
20.1
0.7
0.4
0.9
1.9
1998
42.8
9.5
19.6
0.6
0.3
0.8
1.8
1999
41.5
9.7
19.1
0.6
0.3
0.9
1.8
2000
2001 f
2002 f
41.4
40.3
40.3
9.6
9.6
9.7
18.6
18.5
18.7
0.6
0.6
0.5
0.3
0.3
0.3
0.9
0.8
0.7
1.8
1.7
1.6
---
(annual percentage change)
1975
---
---
1976
0.1
7.8
-3.2
6.8
-2.5
-0.8
1977
-2.6
7.4
0.7
10.0
0.8
2.5
5.2
1978
-2.2
5.7
2.0
13.1
5.1
13.3
11.2
1979
-2.2
3.6
-0.6
24.2
0.0
5.5
12.6
1980
-0.9
-0.5
-0.3
18.0
0.2
2.0
9.5
1981
-0.4
-0.6
-1.5
20.7
-1.1
2.0
11.3
1982
0.8
-0.4
-1.9
-17.6
-1.5
-4.0
-11.4
1983
-1.3
-0.1
2.7
-13.2
4.3
3.1
-5.4
1984
-1.3
-2.2
2.1
-4.5
3.8
3.0
-0.5
1985
-1.8
-2.4
1.7
-3.5
3.0
10.1
2.2
1986
0.1
-9.9
2.4
-3.4
3.6
12.4
3.5
1987
-0.1
-2.5
2.2
-7.5
-0.1
-1.6
-3.7
1988
-0.9
1.7
-0.6
-0.1
5.6
-1.6
0.6
1989
-0.4
0.5
-2.5
2.4
3.6
5.1
3.7
1990
-1.7
0.4
0.3
0.6
1.1
6.5
3.0
1991
-0.9
1.1
1.7
-2.3
1.1
8.0
2.5
1992
-0.9
2.2
-2.2
-1.7
-7.6
1.6
-1.6
1993
-0.7
-2.9
-0.1
1.5
-12.4
-1.5
-2.7
1994
-3.3
-0.4
0.8
0.8
-4.6
-8.1
-4.1
1995
-1.6
3.7
-1.2
-2.6
-5.6
-0.1
-2.1
1996
-0.6
2.5
0.9
-8.4
1.0
-0.9
-3.6
1997
-1.3
0.3
-0.1
-5.7
5.1
0.7
-0.9
1998
-0.9
-2.5
-2.5
-9.7
-12.0
-1.9
-6.7
1999
-3.2
1.7
-2.5
0.2
0.1
1.4
0.8
2000
2001 f
2002 f
-0.2
-2.6
0.0
-0.8
-0.4
1.4
-2.7
-0.5
0.9
-2.1
-2.4
-10.9
-3.4
-4.8
-11.6
0.5
-5.7
-8.5
-1.1
-4.4
-9.9
---
---
---
---
f - Forecast
1.8
CIHI 2002
148
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.2—Part 2
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
E
Capital Public Health &
Administration
Pre-payment
Administration
Other Health Spending
Health
Other
Research
F
G
(percentage distribution of $' 000,000)
Sub-Total
Grand
Total
H
A+B+C+D
+E+F+G+H
1.7
---
1.7
4.0
5.5
1.5
0.8
1.7
4.0
100.0
2.0
---
2.0
3.4
5.8
1.4
0.7
1.8
3.9
100.0
2.2
---
2.2
3.3
6.1
1.3
0.8
2.0
4.1
100.0
2.5
---
2.5
3.5
5.5
1.3
0.8
2.2
4.3
100.0
2.6
---
2.6
3.8
5.6
1.3
0.8
2.4
4.5
100.0
2.7
---
2.7
3.8
5.6
1.2
0.8
2.7
4.7
100.0
2.8
---
2.8
3.7
5.6
1.2
0.8
3.1
5.1
100.0
2.9
---
2.9
3.9
5.7
1.1
0.8
3.1
5.0
100.0
3.1
---
3.1
4.1
5.5
1.0
0.8
3.2
5.0
100.0
3.4
---
3.4
4.1
5.7
1.0
0.9
3.3
5.1
100.0
3.7
---
3.7
4.1
5.9
0.8
0.9
3.5
5.2
100.0
4.1
---
4.1
4.2
5.7
0.8
1.0
3.7
5.6
100.0
4.3
---
4.3
4.0
5.6
0.8
0.9
3.8
5.6
100.0
4.5
---
4.5
4.1
5.4
0.8
0.9
4.1
5.9
100.0
4.7
---
4.7
4.1
5.5
0.8
0.9
4.4
6.1
100.0
5.0
---
5.0
3.8
5.7
0.7
1.0
4.8
6.5
100.0
5.3
---
5.3
3.4
5.7
0.7
0.9
4.9
6.6
100.0
5.6
---
5.6
3.3
5.9
0.7
1.0
5.0
6.8
100.0
5.9
---
5.9
3.2
6.2
0.7
1.0
5.4
7.1
100.0
5.9
---
5.9
3.7
6.9
0.6
1.0
5.8
7.4
100.0
6.4
---
6.4
3.5
7.2
0.7
0.9
5.9
7.5
100.0
6.3
---
6.3
3.2
7.4
0.6
0.9
6.0
7.5
100.0
6.5
---
6.5
3.2
7.2
0.6
1.4
6.1
8.1
100.0
6.8
---
6.8
3.2
8.1
0.6
1.3
6.2
8.2
100.0
7.2
---
7.2
4.1
8.2
0.6
1.5
6.4
8.5
100.0
7.7
8.1
8.3
-------
7.7
8.1
8.3
4.5
5.2
5.4
8.4
8.7
8.4
0.6
0.6
0.6
1.2
1.1
1.2
6.3
6.2
6.0
8.0
7.9
7.7
100.0
100.0
100.0
---
---
---
---
---
---
---
---
---
17.0
---
17.0
-16.2
5.3
-7.2
-7.0
8.0
-0.6
---
12.4
---
12.4
-4.1
4.4
-4.2
11.6
9.5
5.0
---
11.8
---
11.8
7.2
-9.9
-1.3
4.6
8.0
4.3
---
5.9
---
5.9
7.9
1.3
-2.5
1.8
8.9
4.0
---
4.1
---
4.1
0.2
1.6
-6.9
-1.9
13.0
4.5
---
3.1
---
3.1
-2.7
-0.7
-3.1
0.0
15.0
7.7
---
2.7
---
2.7
5.3
1.5
-3.8
-5.0
0.6
-1.4
---
(annual percentage change)
---
7.6
---
7.6
5.7
-3.2
-10.0
4.8
3.5
0.7
---
7.7
---
7.7
-0.2
3.4
-3.5
6.6
2.2
1.8
---
10.5
---
10.5
0.8
4.4
-16.1
5.9
6.3
2.0
---
9.2
---
9.2
1.1
-4.8
3.8
10.8
6.0
6.5
---
5.0
---
5.0
-4.5
-1.9
0.3
-11.9
3.7
0.3
---
4.8
---
4.8
2.4
-2.8
-3.2
-1.0
8.2
5.0
---
5.4
---
5.4
0.0
1.6
-4.4
3.9
6.0
4.2
---
6.6
---
6.6
-5.7
3.2
-5.1
4.5
9.1
6.6
---
5.3
---
5.3
-10.9
0.5
-5.6
-7.1
3.4
0.8
---
6.6
---
6.6
-4.0
4.6
-1.6
15.3
1.9
3.4
---
4.1
---
4.1
-3.2
4.9
-2.3
-5.0
6.9
4.1
---
0.0
---
0.0
16.2
10.3
-3.6
-2.6
7.3
4.9
---
8.7
---
8.7
-6.4
4.2
0.1
-3.8
2.5
1.4
---
-1.2
---
-1.2
-7.7
3.2
-0.3
-0.9
0.6
0.4
---
3.9
---
3.9
0.2
-2.8
-4.2
48.5
1.9
7.1
---
3.8
---
3.8
-0.4
12.1
4.4
-2.3
2.3
1.7
---
6.1
---
6.1
28.3
1.3
-3.8
11.8
2.4
3.4
---
6.7
5.8
1.7
-------
6.7
5.8
1.7
10.2
16.7
3.6
3.0
3.2
-3.0
-3.9
-2.1
-4.1
-20.8
-7.9
6.3
-1.6
-1.4
-3.6
-5.1
-2.4
-2.3
------CIHI 2002
149
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.3—Part 1
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars
Hospitals
Other
Institutions
Physicians
Dental
Services
Year
A
B
Other Professionals
Vision
Other
Care
Services
C
Sub-Total
D
($' per capita)
1975
221.96
34.39
78.35
2.37
1.55
2.02
5.94
1976
254.91
42.57
87.06
2.91
1.73
2.30
6.94
1977
268.55
49.48
94.92
3.46
1.89
2.55
7.90
1978
286.29
57.00
105.51
4.26
2.17
3.15
9.58
1979
309.35
65.25
115.88
5.85
2.39
3.67
11.92
1980
350.16
74.16
131.99
7.88
2.74
4.28
14.90
1981
407.98
86.17
152.10
11.13
3.17
5.10
19.41
1982
477.77
99.67
173.31
10.66
3.63
5.69
19.98
1983
519.31
109.62
196.05
10.19
4.17
6.46
20.82
1984
544.19
113.83
212.62
10.34
4.59
7.07
22.00
1985
570.28
118.56
230.71
10.64
5.05
8.30
23.99
1986
610.60
114.26
252.79
11.00
5.60
9.99
26.58
1987
648.55
118.42
274.72
10.82
5.95
10.45
27.22
1988
690.24
129.42
293.40
11.62
6.75
11.05
29.41
1989
741.60
140.31
308.68
12.84
7.54
12.52
32.89
1990
779.02
150.42
330.62
13.80
8.14
14.24
36.18
1991
829.11
163.27
360.97
14.47
8.84
16.52
39.83
1992
849.85
172.58
365.03
14.71
8.44
17.36
40.51
1993
838.57
166.60
362.50
14.84
7.35
16.99
39.18
1994
812.30
166.28
366.21
14.99
7.03
15.65
37.66
1995
792.43
170.94
358.79
14.47
6.58
15.50
36.55
1996
780.00
173.43
358.66
13.12
6.58
15.20
34.90
1997
792.83
179.19
368.77
12.74
7.12
15.76
35.62
1998
836.44
185.97
382.71
12.24
6.67
16.46
35.36
1999
858.92
200.64
395.71
13.01
7.09
17.71
37.80
2000
926.67
215.23
416.39
13.78
7.40
19.25
40.43
2001 f
968.43
229.93
444.34
14.42
7.56
19.47
41.45
2002 f
1,017.76
245.15
471.26
13.51
7.02
18.73
39.26
(annual percentage change)
1975
---
---
---
---
---
---
---
1976
14.8
23.8
11.1
22.6
11.9
13.9
16.9
1977
5.4
16.3
9.0
19.0
9.1
11.0
13.9
1978
6.6
15.2
11.2
23.3
14.6
23.5
21.3
1979
8.1
14.5
9.8
37.2
10.5
16.5
24.4
1980
13.2
13.6
13.9
34.8
14.4
16.5
25.1
1981
16.5
16.2
15.2
41.2
15.7
19.3
30.2
1982
17.1
15.7
13.9
-4.3
14.4
11.6
2.9
1983
8.7
10.0
13.1
-4.4
14.8
13.5
4.2
1984
4.8
3.8
8.4
1.4
10.2
9.3
5.6
1985
4.8
4.2
8.5
2.9
9.9
17.5
9.1
1986
7.1
-3.6
9.6
3.4
10.9
20.3
10.8
1987
6.2
3.6
8.7
-1.6
6.3
4.6
2.4
1988
6.4
9.3
6.8
7.3
13.4
5.7
8.1
1989
7.4
8.4
5.2
10.5
11.7
13.3
11.8
1990
5.0
7.2
7.1
7.5
8.0
13.8
10.0
1991
6.4
8.5
9.2
4.9
8.6
16.0
10.1
1992
2.5
5.7
1.1
1.6
-4.5
5.1
1.7
1993
-1.3
-3.5
-0.7
0.9
-12.9
-2.1
-3.3
1994
-3.1
-0.2
1.0
1.0
-4.4
-7.9
-3.9
1995
-2.4
2.8
-2.0
-3.5
-6.4
-1.0
-3.0
1996
-1.6
1.5
0.0
-9.3
0.0
-1.9
-4.5
1997
1.6
3.3
2.8
-2.9
8.3
3.7
2.1
1998
5.5
3.8
3.8
-3.9
-6.4
4.4
-0.7
1999
2.7
7.9
3.4
6.3
6.2
7.6
6.9
2000
7.9
7.3
5.2
5.9
4.4
8.7
6.9
2001 f
4.5
6.8
6.7
4.7
2.1
1.2
2.5
2002 f
5.1
6.6
6.1
-6.3
-7.1
-3.8
-5.3
f - Forecast
CIHI 2002
150
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table A.3.3.3—Part 2
Public Sector Health Expenditure by Use of Funds, Canada, 1975 to 2002 - Current Dollars (cont'd)
Prescribed
Drugs
Drugs
NonPrescribed
Drugs
Sub-Total
Capital Public Health &
Administration
E
F
Pre-payment
Administration
Other Health Spending
Health
Other
Research
G
($' per capita)
Sub-Total
Grand
Total
H
A+B+C+D
+E+F+G+H
401.92
6.80
---
6.80
16.27
22.25
6.03
3.08
6.84
15.96
9.14
---
9.14
15.65
26.88
6.42
3.29
8.48
18.20
461.35
11.11
---
11.11
16.25
30.36
6.66
3.98
10.05
20.69
499.27
13.54
---
13.54
18.98
29.82
7.16
4.53
11.83
23.53
544.24
15.84
---
15.84
22.64
33.39
7.71
5.10
14.23
27.04
601.30
687.03
18.84
---
18.84
25.91
38.77
8.20
5.71
18.38
32.30
22.71
---
22.71
29.49
45.01
9.30
6.68
24.72
40.70
803.56
27.09
---
27.09
36.06
53.05
10.40
7.37
28.88
46.65
933.58
32.09
---
32.09
41.99
56.58
10.31
8.51
32.92
51.73
1,028.20
36.69
---
36.69
44.51
62.14
10.56
9.63
35.72
55.91
1,091.88
43.26
---
43.26
47.86
69.22
9.45
10.87
40.49
60.81
1,164.68
50.54
---
50.54
51.78
70.52
10.50
12.89
45.94
69.33
1,246.41
1,325.46
56.44
---
56.44
52.59
73.60
11.20
12.08
50.65
73.92
63.54
---
63.54
57.87
76.86
11.64
12.86
58.89
83.40
1,424.13
72.23
---
72.23
62.39
84.19
12.00
14.40
67.32
93.72
1,536.01
82.23
---
82.23
62.82
92.78
12.17
16.07
78.44
106.68
1,640.76
92.99
---
92.99
60.14
100.11
12.33
16.04
87.08
115.45
1,761.87
102.50
---
102.50
59.73
108.30
12.55
19.13
91.71
123.39
1,821.89
106.08
---
106.08
57.49
112.93
12.20
18.06
97.47
127.73
1,811.09
106.34
---
106.34
66.92
124.81
11.79
17.62
104.81
134.22
1,814.74
114.64
---
114.64
62.14
129.00
11.70
16.80
106.49
135.00
1,799.50
112.19
---
112.19
56.82
131.85
11.55
16.48
106.14
134.17
1,782.01
119.99
---
119.99
58.61
131.92
11.40
25.19
111.36
147.96
1,834.89
132.49
---
132.49
62.13
157.39
12.66
26.19
121.24
160.09
1,952.58
149.18
---
149.18
84.56
169.11
12.92
31.05
131.74
175.71
2,071.64
172.18
---
172.18
100.80
188.26
13.43
26.58
140.23
180.24
2,240.20
195.36
---
195.36
126.13
208.39
14.10
26.27
148.32
188.68
2,402.72
208.88
---
208.88
137.36
212.53
14.21
29.35
150.30
193.86
2,526.06
(annual percentage change)
---
---
---
---
---
---
---
---
34.3
---
34.3
-3.8
20.8
--6.5
--6.7
24.0
14.0
14.8
21.6
---
21.6
3.8
12.9
3.7
20.8
18.5
13.7
8.2
21.8
---
21.8
16.8
-1.8
7.5
14.0
17.7
13.7
9.0
17.0
---
17.0
19.3
12.0
7.7
12.4
20.3
14.9
10.5
19.0
---
19.0
14.5
16.1
6.4
12.1
29.1
19.4
14.3
20.5
---
20.5
13.8
16.1
13.3
16.9
34.5
26.0
17.0
19.3
---
19.3
22.3
17.9
11.8
10.3
16.8
14.6
16.2
18.5
---
18.5
16.5
6.6
-0.9
15.5
14.0
10.9
10.1
14.3
---
14.3
6.0
9.8
2.5
13.2
8.5
8.1
6.2
17.9
---
17.9
7.5
11.4
-10.5
12.9
13.4
8.8
6.7
16.8
---
16.8
8.2
1.9
11.1
18.6
13.4
14.0
7.0
11.7
---
11.7
1.6
4.4
6.6
-6.3
10.3
6.6
6.3
12.6
---
12.6
10.0
4.4
4.0
6.4
16.3
12.8
7.4
13.7
---
13.7
7.8
9.5
3.1
12.0
14.3
12.4
7.9
13.9
---
13.9
0.7
10.2
1.4
11.6
16.5
13.8
6.8
13.1
---
13.1
-4.3
7.9
1.3
-0.2
11.0
8.2
7.4
10.2
---
10.2
-0.7
8.2
1.8
19.2
5.3
6.9
3.4
3.5
---
3.5
-3.7
4.3
-2.8
-5.6
6.3
3.5
-0.6
0.2
---
0.2
16.4
10.5
-3.4
-2.4
7.5
5.1
0.2
7.8
---
7.8
-7.2
3.4
-0.7
-4.6
1.6
0.6
-0.8
-2.1
---
-2.1
-8.6
2.2
-1.3
-1.9
-0.3
-0.6
-1.0
7.0
---
7.0
3.2
0.1
-1.3
52.9
4.9
10.3
3.0
10.4
---
10.4
6.0
19.3
11.1
3.9
8.9
8.2
6.4
12.6
---
12.6
36.1
7.4
2.0
18.6
8.7
9.8
6.1
15.4
---
15.4
19.2
11.3
3.9
-14.4
6.4
2.6
8.1
13.5
---
13.5
25.1
10.7
5.0
-1.2
5.8
4.7
7.3
6.9
---
6.9
8.9
2.0
0.8
11.7
1.3
2.7
5.1
CIHI 2002
151
Series B
Total Health Expenditure by Source of
Finance, by Province/Territory and Canada
(Selected Tables)
153
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.1.1
Total Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
($' 000,000)
1975
1976
1977
1978
1979
264.5
312.8
362.7
412.6
473.3
59.2
62.9
68.7
79.5
96.6
382.5
442.2
469.1
512.5
573.0
277.5
321.9
358.9
404.7
470.0
3,378.8
3,875.2
4,200.7
4,666.6
5,149.6
4,422.8
5,040.8
5,524.6
6,071.9
6,728.0
546.3
629.4
706.0
749.0
823.3
441.2
520.3
587.4
622.4
703.5
992.3
1,158.9
1,272.1
1,465.4
1,781.0
1,384.5
1,629.6
1,833.2
2,046.1
2,289.0
15.9
18.1
18.5
21.3
23.9
35.1
39.0
49.3
56.5
59.0
-----------
12,200.6
14,051.1
15,451.2
17,108.4
19,170.1
1980
1981
1982
1983
1984
528.4
621.3
701.2
773.7
751.2
122.3
136.4
152.4
164.6
171.2
657.2
788.8
919.1
1,004.9
1,125.3
562.5
681.2
819.3
894.6
975.1
5,886.5
6,887.8
7,890.5
8,675.3
9,313.7
7,634.1
8,903.0
10,445.2
11,850.0
13,087.3
971.4
1,153.2
1,332.1
1,478.6
1,592.0
815.7
949.0
1,130.0
1,257.6
1,371.3
2,153.1
2,623.7
3,351.7
3,622.1
3,764.2
2,881.5
3,432.5
3,872.5
4,157.9
4,431.3
26.1
28.2
37.1
38.0
37.9
61.1
73.8
110.4
123.5
125.8
-----------
22,299.9
26,278.9
30,761.4
34,040.9
36,746.6
1985
1986
1987
1988
1989
785.7
812.5
881.6
930.9
991.6
181.3
187.6
202.9
219.5
239.3
1,232.5
1,376.9
1,560.6
1,585.0
1,751.8
1,026.2
1,091.1
1,194.0
1,291.5
1,400.1
10,031.9
10,537.4
11,268.6
12,279.2
13,290.3
14,443.2
16,097.2
17,866.4
19,819.7
21,970.8
1,726.5
1,889.7
1,980.2
2,069.4
2,257.4
1,528.8
1,703.6
1,767.8
1,837.5
2,052.9
4,070.4
4,448.5
4,499.9
4,830.6
5,349.8
4,640.4
4,986.6
5,343.9
5,839.5
6,509.8
39.7
42.6
44.7
45.8
49.5
138.5
166.9
181.3
211.2
232.9
-----------
39,845.2
43,340.7
46,791.9
50,959.8
56,096.3
1990
1991
1992
1993
1994
1,096.4
1,153.2
1,197.4
1,209.1
1,248.0
256.2
280.6
295.0
311.7
313.3
1,868.2
1,973.8
2,035.2
2,028.3
2,025.1
1,533.5
1,629.3
1,699.8
1,739.1
1,791.6
14,311.5
15,634.6
16,376.1
16,904.1
17,310.9
23,799.1
26,194.4
27,631.8
28,133.5
28,769.3
2,484.3
2,576.0
2,702.9
2,749.5
2,801.9
2,252.2
2,319.8
2,325.4
2,301.9
2,382.3
5,749.4
6,062.5
6,430.7
6,520.4
6,305.4
7,376.3
8,127.4
8,769.7
9,297.4
9,849.2
53.6
62.6
67.4
79.6
93.0
246.8
279.5
279.6
287.1
286.2
-----------
61,027.6
66,293.6
69,810.9
71,561.5
73,176.3
1995
1996
1997
1998
1999
1,262.5
1,260.8
1,306.8
1,434.1
1,573.3
326.3
338.0
339.9
358.4
375.5
2,105.5
2,094.6
2,362.6
2,544.9
2,658.8
1,807.7
1,814.1
1,855.2
1,917.5
2,067.4
17,281.7
16,966.6
17,764.8
18,907.0
19,885.7
29,361.6
29,765.7
30,885.0
32,973.3
35,258.2
2,906.9
2,962.5
3,090.5
3,278.0
3,660.7
2,437.6
2,486.6
2,656.0
2,773.0
2,957.6
6,085.8
6,310.2
7,067.5
7,592.3
8,642.1
10,156.3
10,378.9
10,836.6
11,401.4
12,237.0
94.7
109.2
102.0
103.1
108.0
293.9
292.6
307.3
351.6
232.7
--------131.4
74,120.5
74,779.7
78,574.2
83,634.6
89,788.6
2000
2001 f
2002 f
1,683.0
1,843.5
1,906.6
396.3
431.4
470.8
2,800.4
2,958.8
3,121.5
2,224.3
2,428.5
2,597.0
21,185.3
22,812.6
23,721.4
38,746.5
41,513.1
44,337.3
4,012.3
4,250.2
4,551.2
3,123.4
3,350.1
3,489.7
9,521.5
10,768.4
11,710.3
13,235.9
14,707.5
15,730.6
115.3
127.7
136.7
214.4
239.2
254.3
161.6
174.1
185.7
97,420.0
105,605.2
112,213.0
1975
1976
1977
1978
1979
--18.3
15.9
13.8
14.7
--6.2
9.3
15.7
21.5
--15.6
6.1
9.2
11.8
--16.0
11.5
12.8
16.2
--14.7
8.4
11.1
10.4
--14.0
9.6
9.9
10.8
--15.2
12.2
6.1
9.9
--17.9
12.9
6.0
13.0
--16.8
9.8
15.2
21.5
--17.7
12.5
11.6
11.9
--13.6
2.4
15.4
12.2
--11.3
26.3
14.6
4.3
-----------
--15.2
10.0
10.7
12.1
1980
1981
1982
1983
1984
11.6
17.6
12.9
10.3
-2.9
26.6
11.5
11.7
8.0
4.1
14.7
20.0
16.5
9.3
12.0
19.7
21.1
20.3
9.2
9.0
14.3
17.0
14.6
9.9
7.4
13.5
16.6
17.3
13.4
10.4
18.0
18.7
15.5
11.0
7.7
16.0
16.3
19.1
11.3
9.0
20.9
21.9
27.7
8.1
3.9
25.9
19.1
12.8
7.4
6.6
9.0
7.9
31.9
2.4
-0.4
3.6
20.9
49.5
11.9
1.8
-----------
16.3
17.8
17.1
10.7
7.9
1985
1986
1987
1988
1989
4.6
3.4
8.5
5.6
6.5
5.9
3.5
8.2
8.2
9.1
9.5
11.7
13.3
1.6
10.5
5.2
6.3
9.4
8.2
8.4
7.7
5.0
6.9
9.0
8.2
10.4
11.5
11.0
10.9
10.9
8.4
9.5
4.8
4.5
9.1
11.5
11.4
3.8
3.9
11.7
8.1
9.3
1.2
7.3
10.7
4.7
7.5
7.2
9.3
11.5
4.8
7.2
5.1
2.3
8.2
10.2
20.5
8.6
16.5
10.3
-----------
8.4
8.8
8.0
8.9
10.1
1990
1991
1992
1993
1994
10.6
5.2
3.8
1.0
3.2
7.0
9.5
5.1
5.7
0.5
6.6
5.7
3.1
-0.3
-0.2
9.5
6.2
4.3
2.3
3.0
7.7
9.2
4.7
3.2
2.4
8.3
10.1
5.5
1.8
2.3
10.1
3.7
4.9
1.7
1.9
9.7
3.0
0.2
-1.0
3.5
7.5
5.4
6.1
1.4
-3.3
13.3
10.2
7.9
6.0
5.9
8.2
16.8
7.7
18.2
16.9
6.0
13.2
0.1
2.7
-0.3
-----------
8.8
8.6
5.3
2.5
2.3
1995
1996
1997
1998
1999
1.2
-0.1
3.7
9.7
9.7
4.1
3.6
0.5
5.5
4.8
4.0
-0.5
12.8
7.7
4.5
0.9
0.4
2.3
3.4
7.8
-0.2
-1.8
4.7
6.4
5.2
2.1
1.4
3.8
6.8
6.9
3.7
1.9
4.3
6.1
11.7
2.3
2.0
6.8
4.4
6.7
-3.5
3.7
12.0
7.4
13.8
3.1
2.2
4.4
5.2
7.3
1.8
15.2
-6.6
1.1
4.7
2.7
-0.4
5.0
14.4
-33.8
-----------
1.3
0.9
5.1
6.4
7.4
7.0
9.5
3.4
5.5
8.9
9.1
5.3
5.7
5.5
7.6
9.2
6.9
6.5
7.7
4.0
9.9
7.1
6.8
9.6
5.9
7.1
5.6
7.3
4.2
10.2
13.1
8.7
8.2
11.1
7.0
6.8
10.8
7.0
-7.9
11.6
6.3
23.0
7.7
6.7
8.5
8.4
6.3
(annual percentage change)
2000
2001 f
2002 f
f - Forecast
CIHI 2002
155
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.1.2
Total Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Year
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
($' per capita)
1975
1976
1977
1978
1979
475.49
555.96
641.63
727.52
831.17
502.62
529.82
572.56
653.05
785.23
462.74
529.45
558.65
606.81
674.67
409.87
466.84
515.80
578.47
668.42
533.80
605.80
653.09
724.49
796.26
531.61
599.11
649.52
706.71
776.66
533.03
610.01
680.13
719.35
793.63
480.92
558.53
621.67
653.80
733.12
548.65
619.96
653.15
724.78
849.04
553.88
643.16
713.40
782.74
859.55
726.48
804.44
810.11
898.95
997.96
818.67
880.95
1,103.96
1,248.03
1,289.33
-----------
527.20
599.20
651.23
713.92
792.08
1980
1981
1982
1983
1984
922.83
1,080.87
1,220.41
1,334.99
1,294.84
988.59
1,102.17
1,230.15
1,311.83
1,352.42
770.61
923.01
1,068.72
1,156.14
1,282.96
796.61
964.41
1,156.84
1,250.58
1,352.42
904.59
1,051.94
1,199.29
1,313.99
1,404.54
872.93
1,010.40
1,170.69
1,310.60
1,426.89
938.88
1,112.70
1,272.57
1,393.50
1,485.31
843.20
972.49
1,144.55
1,255.28
1,350.43
982.07
1,143.63
1,415.24
1,515.28
1,574.95
1,050.40
1,215.52
1,347.92
1,431.06
1,504.38
1,072.68
1,177.79
1,517.90
1,611.05
1,585.25
1,319.34
1,552.38
2,228.99
2,420.07
2,392.39
-----------
909.60
1,058.76
1,224.70
1,341.94
1,434.99
1985
1986
1987
1988
1989
1,356.22
1,409.35
1,532.85
1,618.94
1,720.31
1,419.84
1,460.72
1,578.24
1,697.56
1,839.78
1,392.55
1,548.25
1,746.68
1,766.19
1,938.06
1,418.05
1,504.73
1,640.41
1,768.18
1,904.27
1,505.02
1,570.78
1,661.34
1,795.31
1,917.93
1,553.46
1,705.61
1,852.42
2,013.43
2,173.22
1,595.26
1,731.02
1,803.36
1,877.74
2,045.64
1,490.81
1,655.21
1,711.66
1,787.35
2,014.06
1,693.94
1,830.00
1,847.69
1,967.88
2,143.51
1,560.20
1,659.95
1,752.03
1,874.24
2,035.23
1,630.01
1,739.80
1,740.54
1,720.11
1,826.11
2,546.73
3,052.20
3,293.31
3,791.81
4,084.65
-----------
1,541.84
1,660.53
1,769.08
1,901.60
2,055.85
1990
1991
1992
1993
1994
1,896.75
1,989.96
2,063.89
2,083.90
2,171.01
1,962.66
2,153.40
2,253.72
2,355.36
2,343.72
2,053.69
2,157.03
2,213.75
2,195.84
2,186.18
2,071.93
2,185.34
2,271.12
2,320.23
2,385.78
2,043.20
2,213.04
2,302.33
2,359.19
2,401.86
2,310.69
2,512.02
2,614.05
2,631.64
2,657.05
2,247.04
2,321.57
2,428.29
2,458.48
2,493.15
2,236.27
2,313.65
2,316.13
2,286.03
2,359.48
2,256.76
2,338.45
2,441.07
2,441.42
2,331.10
2,241.11
2,409.25
2,527.08
2,603.20
2,675.15
1,928.48
2,164.15
2,227.76
2,599.87
3,096.09
4,190.42
4,586.61
4,480.52
4,517.40
4,391.79
-----------
2,203.10
2,365.02
2,460.16
2,493.16
2,520.19
1995
1996
1997
1998
1999
2,222.88
2,249.06
2,358.60
2,629.85
2,908.69
2,420.60
2,482.19
2,483.43
2,618.48
2,726.12
2,269.57
2,249.25
2,528.10
2,718.65
2,824.96
2,404.59
2,409.13
2,459.73
2,545.33
2,736.36
2,386.50
2,332.49
2,432.69
2,581.64
2,705.10
2,677.77
2,681.39
2,745.45
2,895.59
3,058.52
2,572.99
2,611.64
2,719.14
2,880.74
3,203.98
2,403.57
2,439.09
2,598.74
2,705.72
2,883.89
2,221.22
2,269.35
2,491.02
2,611.86
2,919.98
2,684.00
2,673.57
2,736.72
2,852.40
3,037.78
3,066.38
3,417.58
3,163.70
3,271.35
3,477.16
4,414.43
4,330.53
4,536.55
5,210.14
5,680.42
--------4,893.77
2,525.07
2,520.22
2,620.26
2,764.92
2,942.99
2000
2001 f
2002 f
3,128.88
3,453.48
3,586.55
2,864.72
3,105.76
3,364.66
2,971.78
3,138.06
3,304.02
2,943.69
3,212.52
3,432.23
2,869.95
3,075.42
3,181.85
3,312.35
3,490.00
3,673.86
3,499.74
3,698.65
3,954.61
3,056.28
3,293.78
3,449.01
3,163.42
3,520.10
3,761.03
3,259.98
3,585.82
3,798.49
3,767.71
4,232.18
4,567.89
5,248.68
5,802.74
6,142.03
5,876.36
6,190.94
6,466.58
3,163.93
3,394.51
3,572.07
(annual percentage change)
1975
1976
1977
1978
1979
--16.9
15.4
13.4
14.2
--5.4
8.1
14.1
20.2
--14.4
5.5
8.6
11.2
--13.9
10.5
12.2
15.6
--13.5
7.8
10.9
9.9
--12.7
8.4
8.8
9.9
--14.4
11.5
5.8
10.3
--16.1
11.3
5.2
12.1
--13.0
5.4
11.0
17.1
--16.1
10.9
9.7
9.8
--10.7
0.7
11.0
11.0
--7.6
25.3
13.1
3.3
-----------
--13.7
8.7
9.6
10.9
1980
1981
1982
1983
1984
11.0
17.1
12.9
9.4
-3.0
25.9
11.5
11.6
6.6
3.1
14.2
19.8
15.8
8.2
11.0
19.2
21.1
20.0
8.1
8.1
13.6
16.3
14.0
9.6
6.9
12.4
15.7
15.9
12.0
8.9
18.3
18.5
14.4
9.5
6.6
15.0
15.3
17.7
9.7
7.6
15.7
16.5
23.8
7.1
3.9
22.2
15.7
10.9
6.2
5.1
7.5
9.8
28.9
6.1
-1.6
2.3
17.7
43.6
8.6
-1.1
-----------
14.8
16.4
15.7
9.6
6.9
1985
1986
1987
1988
1989
4.7
3.9
8.8
5.6
6.3
5.0
2.9
8.0
7.6
8.4
8.5
11.2
12.8
1.1
9.7
4.9
6.1
9.0
7.8
7.7
7.2
4.4
5.8
8.1
6.8
8.9
9.8
8.6
8.7
7.9
7.4
8.5
4.2
4.1
8.9
10.4
11.0
3.4
4.4
12.7
7.6
8.0
1.0
6.5
8.9
3.7
6.4
5.5
7.0
8.6
2.8
6.7
0.0
-1.2
6.2
6.5
19.8
7.9
15.1
7.7
-----------
7.4
7.7
6.5
7.5
8.1
1990
1991
1992
1993
1994
10.3
4.9
3.7
1.0
4.2
6.7
9.7
4.7
4.5
-0.5
6.0
5.0
2.6
-0.8
-0.4
8.8
5.5
3.9
2.2
2.8
6.5
8.3
4.0
2.5
1.8
6.3
8.7
4.1
0.7
1.0
9.8
3.3
4.6
1.2
1.4
11.0
3.5
0.1
-1.3
3.2
5.3
3.6
4.4
0.0
-4.5
10.1
7.5
4.9
3.0
2.8
5.6
12.2
2.9
16.7
19.1
2.6
9.5
-2.3
0.8
-2.8
-----------
7.2
7.3
4.0
1.3
1.1
1995
1996
1997
1998
1999
2.4
1.2
4.9
11.5
10.6
3.3
2.5
0.0
5.4
4.1
3.8
-0.9
12.4
7.5
3.9
0.8
0.2
2.1
3.5
7.5
-0.6
-2.3
4.3
6.1
4.8
0.8
0.1
2.4
5.5
5.6
3.2
1.5
4.1
5.9
11.2
1.9
1.5
6.5
4.1
6.6
-4.7
2.2
9.8
4.9
11.8
0.3
-0.4
2.4
4.2
6.5
-1.0
11.5
-7.4
3.4
6.3
0.5
-1.9
4.8
14.8
9.0
-----------
0.2
-0.2
4.0
5.5
6.4
7.6
5.1
5.2
7.6
6.1
8.3
9.2
6.0
8.3
7.3
8.4
-7.6
20.1
7.5
10.4
3.9
8.4
8.3
5.6
5.3
9.1
6.8
7.2
3.5
5.4
5.3
5.7
6.9
7.8
4.7
11.3
6.8
10.0
5.9
12.3
7.9
10.6
5.8
5.4
4.5
7.3
5.2
2000
2001 f
2002 f
f - Forecast
CIHI 2002
156
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.1.3
Total Health Expenditure as a Percent of (Provincial/Territorial) G.D.P., by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
(percentage)
1975
1976
1977
1978
1979
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
7.0
7.0
7.0
7.0
6.8
1980
1981
1982
1983
1984
--12.1
12.5
12.9
11.8
--12.8
13.2
12.1
12.3
--9.9
10.0
9.7
9.8
--10.7
11.6
11.1
11.1
--8.6
9.3
9.4
9.3
--6.8
7.5
7.7
7.6
--8.5
9.5
9.8
9.4
--6.4
7.5
7.9
8.1
--4.9
5.9
6.2
6.0
--7.7
8.6
8.8
8.9
--5.9
7.9
8.6
8.3
--7.4
8.6
8.6
8.5
-----------
7.1
7.3
8.1
8.3
8.2
1985
1986
1987
1988
1989
11.8
11.2
11.4
11.0
11.0
12.5
11.5
11.7
11.5
11.6
9.9
10.3
10.8
10.4
10.7
10.9
10.4
10.3
10.4
10.7
9.3
9.0
8.8
8.7
9.0
7.6
7.7
7.7
7.7
7.9
9.3
9.8
9.7
9.4
9.7
8.5
9.6
9.7
9.7
10.3
6.1
7.7
7.5
7.6
7.9
8.7
8.8
8.5
8.4
8.6
8.2
6.8
5.1
4.8
4.9
8.4
10.8
10.8
10.6
10.9
-----------
8.2
8.5
8.4
8.3
8.5
1990
1991
1992
1993
1994
11.9
12.0
12.5
12.4
12.2
11.8
12.4
12.6
12.6
12.4
11.0
11.2
11.2
11.1
10.8
11.4
11.9
12.1
11.8
11.7
9.3
10.1
10.3
10.4
10.2
8.4
9.3
9.6
9.6
9.2
10.3
10.7
11.1
11.2
10.8
10.6
10.8
11.0
10.0
9.7
7.8
8.3
8.6
8.0
7.2
9.3
9.9
10.1
9.9
9.8
5.1
6.6
6.2
9.0
10.2
11.3
12.8
12.9
12.7
12.0
-----------
9.0
9.7
10.0
9.8
9.5
1995
1996
1997
1998
1999
11.9
12.1
12.4
12.8
12.9
12.3
12.0
12.1
12.0
11.8
10.9
10.7
11.6
11.9
11.6
11.0
10.9
11.0
10.9
10.9
9.7
9.4
9.4
9.6
9.5
8.9
8.8
8.6
8.7
8.6
10.8
10.4
10.4
10.6
11.5
9.2
8.6
9.1
9.4
9.7
6.6
6.4
6.6
7.1
7.4
9.6
9.5
9.5
9.9
10.1
9.0
9.7
9.2
9.5
10.0
12.2
11.6
11.4
13.3
10.2
--------17.3
9.1
8.9
8.9
9.1
9.2
2000
2001 f
2002 f
12.2
13.4
12.4
11.7
12.4
12.7
11.6
11.7
11.8
11.1
11.8
12.3
9.5
9.9
9.8
8.9
9.4
9.5
12.0
12.2
12.7
9.3
10.1
10.3
6.6
7.1
7.6
10.2
11.2
11.7
10.0
10.7
11.4
8.0
7.5
7.9
19.3
19.3
20.6
9.1
9.7
9.8
(annual percentage change)
1975
1976
1977
1978
1979
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
-----------
--0.0
-0.5
-0.2
-1.9
1980
1981
1982
1983
1984
----3.7
3.4
-8.8
----3.4
-8.2
1.6
----1.1
-3.1
1.5
----8.2
-4.3
-0.5
----8.2
2.0
-1.7
----10.8
1.8
-1.2
----12.0
3.3
-4.3
----17.2
4.6
2.2
----20.1
5.1
-2.6
----12.4
1.8
1.5
----33.1
9.6
-3.7
----16.8
0.2
-1.7
-----------
3.4
3.1
11.1
2.2
-1.2
1985
1986
1987
1988
1989
0.3
-5.1
1.3
-3.2
0.3
1.8
-8.3
1.5
-1.7
1.2
1.1
3.3
5.3
-4.2
3.7
-1.0
-4.7
-1.1
0.6
2.7
0.6
-3.7
-2.5
-0.6
2.7
0.9
1.1
0.3
-0.2
2.0
-0.6
5.3
-1.0
-3.2
2.8
5.9
12.4
1.4
0.3
5.4
0.8
25.9
-2.4
0.9
5.1
-2.5
1.7
-3.1
-1.6
2.4
-1.3
-17.0
-25.4
-6.2
1.6
-1.6
28.8
0.6
-1.7
2.5
-----------
0.4
3.1
-1.0
-0.7
2.6
1990
1991
1992
1993
1994
7.9
1.1
4.2
-1.3
-1.7
1.6
5.3
1.1
0.3
-1.5
2.3
1.7
0.6
-1.7
-1.9
6.8
4.8
1.4
-2.3
-1.0
4.2
8.0
2.6
0.8
-2.5
6.8
10.0
4.2
-0.6
-3.6
6.3
4.4
3.2
1.1
-3.5
3.2
2.2
1.1
-8.4
-3.1
-1.2
6.0
3.2
-6.4
-10.8
7.9
6.8
1.2
-1.7
-0.8
4.6
29.2
-5.3
45.5
13.3
3.8
13.1
0.6
-1.6
-5.3
-----------
5.2
7.8
3.0
-1.3
-3.5
1995
1996
1997
1998
1999
-2.5
2.1
2.5
3.4
0.6
-1.4
-2.3
1.4
-0.9
-1.6
0.6
-1.6
8.1
2.5
-2.7
-5.8
-1.1
0.9
-1.3
0.0
-4.0
-3.6
0.3
2.2
-1.8
-3.6
-1.3
-2.4
1.5
-1.2
-0.1
-3.3
-0.3
1.9
8.3
-5.2
-6.9
6.0
3.0
3.3
-7.7
-3.2
3.2
7.0
5.0
-1.9
-0.8
-0.6
4.1
2.9
-11.5
7.0
-4.8
3.0
5.7
2.1
-5.4
-1.5
16.1
-23.1
-----------
-3.7
-2.3
-0.4
2.7
0.2
2000
-5.3
-1.3
-0.1
2.2
-0.1
3.7
4.6
-4.5
-11.3
0.8
-0.5
-21.6
11.5
-0.1
2001 f
2002 f
9.6
-7.6
6.2
2.6
1.6
0.6
6.5
3.5
5.1
-1.4
4.6
2.1
2.2
3.3
8.6
2.6
8.1
6.3
9.8
4.4
7.4
6.7
-6.7
6.0
0.2
6.4
5.7
1.8
f - Forecast
CIHI 2002
157
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.2.1
Private Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
($' 000,000)
1975
1976
1977
1978
1979
59.4
86.9
121.8
146.3
164.4
16.0
15.6
16.1
20.9
31.8
81.1
100.8
99.6
109.5
127.8
62.7
67.5
74.5
91.1
118.7
715.5
755.0
772.8
843.2
901.6
1,094.3
1,205.4
1,360.0
1,596.7
1,874.6
122.0
129.7
151.9
160.0
189.0
112.6
126.5
143.7
144.6
159.2
234.6
260.4
293.3
337.7
389.1
388.8
471.2
556.8
599.9
643.4
3.5
4.3
4.5
4.8
5.5
8.7
9.3
10.5
11.7
12.4
-----------
2,899.2
3,232.6
3,605.4
4,066.3
4,617.4
1980
1981
1982
1983
1984
178.6
210.8
218.4
234.7
191.8
47.1
49.3
50.4
51.1
49.9
147.8
166.8
199.2
215.9
248.5
147.2
177.7
210.1
232.6
265.6
1,089.0
1,397.1
1,528.6
1,643.1
1,827.6
2,126.9
2,377.6
2,834.2
3,253.5
3,624.8
232.3
287.6
315.1
337.6
367.8
167.2
185.9
204.1
219.1
258.6
493.1
581.5
786.9
720.5
767.5
807.9
879.1
943.1
1,026.9
1,159.2
6.1
6.2
6.8
6.7
6.9
13.2
14.6
15.4
16.9
18.1
-----------
5,456.5
6,334.1
7,312.3
7,958.6
8,786.3
1985
197.1
52.9
285.3
274.1
2,104.4
3,999.5
415.6
333.2
831.3
1,227.1
6.8
19.6
---
9,746.9
1986
169.6
49.6
353.7
285.9
2,486.1
4,367.1
463.9
377.7
910.6
1,317.2
5.6
21.7
---
10,808.7
1987
188.0
53.3
395.0
305.1
2,632.2
4,854.5
449.9
395.5
985.5
1,444.9
5.6
23.9
---
11,733.5
1988
197.1
56.5
420.1
330.4
2,850.8
5,321.9
435.2
369.2
1,184.9
1,596.8
5.2
27.3
---
12,795.4
1989
203.9
64.9
470.3
352.4
3,181.7
5,876.9
484.2
423.7
1,318.8
1,773.0
5.3
29.3
---
14,184.3
1990
220.6
70.0
490.4
397.4
3,497.4
6,466.2
533.2
460.1
1,422.5
1,986.0
5.0
28.4
---
15,577.1
1991
247.5
76.8
518.8
442.4
3,819.3
7,038.2
570.0
490.9
1,505.1
2,159.5
6.1
32.3
---
16,906.9
1992
269.1
85.8
554.5
466.7
4,141.5
7,573.7
602.6
505.8
1,584.2
2,291.2
6.9
29.7
---
18,112.0
1993
284.2
93.5
579.5
503.0
4,444.5
8,252.9
660.2
574.1
1,719.8
2,427.0
10.6
28.3
---
19,577.5
1994
299.7
96.3
608.2
519.4
4,636.6
8,700.5
686.3
603.5
1,777.6
2,518.8
9.9
26.6
---
20,483.5
1995
289.3
103.5
662.6
484.7
4,572.8
9,418.0
727.5
616.9
1,802.3
2,586.6
10.5
23.6
---
21,298.3
1996
286.3
105.0
653.9
488.7
4,711.9
9,677.5
777.2
624.3
1,843.8
2,690.2
18.1
27.3
---
21,904.0
1997
285.9
109.9
690.6
549.5
4,960.8
10,390.1
838.1
676.2
2,131.0
2,875.5
16.9
26.4
---
23,550.9
1998
327.0
112.6
754.5
547.2
4,983.5
10,911.5
890.5
667.2
2,251.1
3,084.4
15.9
26.8
---
24,572.3
1999
323.1
116.7
754.8
597.2
5,532.2
11,820.7
941.0
699.0
2,489.5
3,264.0
16.9
20.7
8.3
26,584.2
2000
2001 f
2002 f
361.9
406.8
418.0
118.4
124.3
128.2
826.8
908.3
952.1
639.2
698.3
735.9
5,829.4
6,132.3
6,467.5
12,655.1
13,827.5
14,798.6
1,006.8
1,049.4
1,138.4
744.5
792.0
816.4
2,733.8
3,007.1
3,267.6
3,480.2
3,859.7
4,085.0
18.0
18.9
19.9
19.6
21.7
22.9
8.8
8.9
9.0
28,442.5
30,855.3
32,859.4
(annual percentage change)
1975
1976
1977
1978
1979
--46.4
40.2
20.1
12.4
---2.5
3.3
29.6
52.1
--24.3
-1.2
9.9
16.8
--7.8
10.3
22.3
30.3
--5.5
2.3
9.1
6.9
--10.2
12.8
17.4
17.4
--6.3
17.1
5.4
18.1
--12.3
13.6
0.6
10.1
--11.0
12.6
15.2
15.2
--21.2
18.2
7.7
7.2
--23.1
4.1
5.7
15.4
--7.0
13.4
11.1
5.9
-----------
--11.5
11.5
12.8
13.6
1980
1981
1982
1983
1984
8.6
18.0
3.6
7.5
-18.3
48.2
4.8
2.2
1.3
-2.3
15.6
12.9
19.4
8.4
15.1
24.0
20.7
18.2
10.7
14.2
20.8
28.3
9.4
7.5
11.2
13.5
11.8
19.2
14.8
11.4
22.9
23.8
9.6
7.1
8.9
5.0
11.2
9.8
7.3
18.1
26.7
17.9
35.3
-8.4
6.5
25.6
8.8
7.3
8.9
12.9
11.5
0.7
9.7
-1.3
3.1
6.4
10.5
5.7
9.8
7.2
-----------
18.2
16.1
15.4
8.8
10.4
1985
1986
1987
1988
1989
2.7
-13.9
10.9
4.8
3.4
6.1
-6.3
7.4
6.1
14.9
14.8
24.0
11.7
6.3
12.0
3.2
4.3
6.7
8.3
6.6
15.1
18.1
5.9
8.3
11.6
10.3
9.2
11.2
9.6
10.4
13.0
11.6
-3.0
-3.3
11.3
28.8
13.4
4.7
-6.7
14.8
8.3
9.5
8.2
20.2
11.3
5.9
7.3
9.7
10.5
11.0
-1.2
-17.3
0.4
-7.5
1.2
8.3
10.5
10.0
14.4
7.5
-----------
10.9
10.9
8.6
9.1
10.9
1990
1991
1992
1993
1994
8.2
12.2
8.7
5.6
5.5
7.7
9.8
11.6
9.0
3.0
4.3
5.8
6.9
4.5
5.0
12.8
11.3
5.5
7.8
3.3
9.9
9.2
8.4
7.3
4.3
10.0
8.8
7.6
9.0
5.4
10.1
6.9
5.7
9.6
3.9
8.6
6.7
3.0
13.5
5.1
7.9
5.8
5.3
8.6
3.4
12.0
8.7
6.1
5.9
3.8
-4.8
20.9
14.1
52.5
-6.7
-3.3
13.7
-7.9
-4.7
-6.1
-----------
9.8
8.5
7.1
8.1
4.6
1995
1996
1997
1998
1999
-3.5
-1.0
-0.1
14.4
-1.2
7.4
1.5
4.7
2.4
3.6
8.9
-1.3
5.6
9.3
0.0
-6.7
0.8
12.5
-0.4
9.1
-1.4
3.0
5.3
0.5
11.0
8.2
2.8
7.4
5.0
8.3
6.0
6.8
7.8
6.3
5.7
2.2
1.2
8.3
-1.3
4.8
1.4
2.3
15.6
5.6
10.6
2.7
4.0
6.9
7.3
5.8
6.4
73.0
-6.9
-5.9
6.2
-11.3
15.5
-3.1
1.6
-22.8
-----------
4.0
2.8
7.5
4.3
8.2
2000
2001 f
2002 f
12.0
12.4
2.7
1.4
5.0
3.1
9.5
9.9
4.8
7.0
9.3
5.4
5.4
5.2
5.5
7.1
9.3
7.0
7.0
4.2
8.5
6.5
6.4
3.1
9.8
10.0
8.7
6.6
10.9
5.8
6.5
5.0
5.3
-5.5
10.9
5.6
f - Forecast
6.2
1.1
1.2
7.0
8.5
6.5
CIHI 2002
159
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.2.2
Private Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
($' per capita)
1975
1976
1977
1978
1979
106.70
154.40
215.42
257.91
288.72
135.81
131.42
134.19
171.57
258.31
98.13
120.69
118.59
129.63
150.52
92.57
97.96
107.02
130.17
168.79
113.05
118.03
120.14
130.90
139.40
131.53
143.27
159.90
185.85
216.40
118.99
125.66
146.30
153.65
182.18
122.75
135.75
152.08
151.90
165.92
129.69
139.32
150.57
167.03
185.49
155.56
185.95
216.69
229.49
241.59
160.46
192.59
197.18
200.48
228.99
202.70
209.75
236.08
258.67
271.21
-----------
125.28
137.85
151.96
169.68
190.78
1980
1981
1982
1983
1984
311.96
366.78
380.15
405.01
330.61
380.69
398.78
407.14
407.23
394.19
173.28
195.17
231.63
248.37
283.28
208.52
251.61
296.65
325.09
368.32
167.35
213.37
232.33
248.88
275.61
243.21
269.83
317.65
359.83
395.21
224.54
277.48
301.03
318.16
343.13
172.83
190.48
206.74
218.67
254.68
224.89
253.47
332.28
301.41
321.10
294.52
311.30
328.28
353.45
393.53
251.77
257.98
276.31
282.65
287.68
284.97
306.50
311.09
331.49
344.96
-----------
222.57
255.20
291.12
313.74
343.11
1985
1986
1987
1988
1989
340.16
294.15
326.90
342.81
353.74
414.66
386.14
414.22
436.94
499.11
322.36
397.71
442.14
468.07
520.28
378.68
394.25
419.14
452.43
479.26
315.70
370.60
388.06
416.81
459.16
430.17
462.72
503.32
540.63
581.30
383.98
424.97
409.77
394.87
438.78
324.94
366.98
382.99
359.12
415.70
345.95
374.60
404.66
482.72
528.39
412.59
438.48
473.73
512.50
554.31
278.88
229.51
219.46
195.93
194.55
361.05
396.70
433.58
490.00
514.35
-----------
377.16
414.12
443.61
477.47
519.84
1990
1991
1992
1993
1994
381.53
427.13
463.88
489.77
521.46
535.89
589.67
655.38
706.43
720.64
539.05
566.96
603.19
627.39
656.61
536.96
593.36
623.61
671.03
691.66
499.31
540.62
582.27
620.28
643.31
627.82
674.96
716.50
771.99
803.56
482.28
513.72
541.36
590.35
610.64
456.84
489.60
503.82
570.14
597.72
558.37
580.53
601.37
643.96
657.18
603.38
640.17
660.23
679.53
684.14
180.78
209.98
229.03
344.92
327.85
481.69
529.44
476.22
445.89
408.36
-----------
562.33
603.15
638.27
682.07
705.45
1995
1996
1997
1998
1999
509.39
510.69
516.01
599.73
597.40
767.52
771.34
803.42
822.79
847.15
714.26
702.15
738.94
806.04
801.99
644.71
648.96
728.56
726.38
790.49
631.48
647.77
679.32
680.46
752.55
858.92
871.78
923.61
958.21
1,025.41
643.94
685.13
737.40
782.58
823.63
608.23
612.34
661.63
651.03
681.56
657.83
663.07
751.10
774.41
841.14
683.55
692.98
726.19
771.66
810.28
339.41
567.70
523.63
503.80
542.89
354.42
403.37
389.80
397.39
505.21
--------309.04
725.57
738.21
785.37
812.35
871.35
2000
2001 f
2002 f
672.75
762.13
786.24
855.68
894.96
916.02
877.46
963.37
1,007.77
845.89
923.79
972.58
789.71
826.71
867.52
1,081.86
1,162.47
1,226.24
878.20
913.26
989.14
728.54
778.67
806.83
908.28
983.01
1,049.46
857.15
941.02
986.42
586.83
624.86
663.81
479.00
526.44
553.75
320.45
316.94
314.14
923.73
991.80
1,046.01
(annual percentage change)
1975
1976
1977
1978
1979
--44.7
39.5
19.7
11.9
---3.2
2.1
27.9
50.6
--23.0
-1.7
9.3
16.1
--5.8
9.3
21.6
29.7
--4.4
1.8
9.0
6.5
--8.9
11.6
16.2
16.4
--5.6
16.4
5.0
18.6
--10.6
12.0
-0.1
9.2
--7.4
8.1
10.9
11.1
--19.5
16.5
5.9
5.3
--20.0
2.4
1.7
14.2
--3.5
12.6
9.6
4.8
-----------
--10.0
10.2
11.7
12.4
1980
1981
1982
1983
1984
8.0
17.6
3.6
6.5
-18.4
47.4
4.8
2.1
0.0
-3.2
15.1
12.6
18.7
7.2
14.1
23.5
20.7
17.9
9.6
13.3
20.0
27.5
8.9
7.1
10.7
12.4
10.9
17.7
13.3
9.8
23.2
23.6
8.5
5.7
7.8
4.2
10.2
8.5
5.8
16.5
21.2
12.7
31.1
-9.3
6.5
21.9
5.7
5.5
7.7
11.3
9.9
2.5
7.1
2.3
1.8
5.1
7.6
1.5
6.6
4.1
-----------
16.7
14.7
14.1
7.8
9.4
1985
1986
1987
1988
1989
2.9
-13.5
11.1
4.9
3.2
5.2
-6.9
7.3
5.5
14.2
13.8
23.4
11.2
5.9
11.2
2.8
4.1
6.3
7.9
5.9
14.5
17.4
4.7
7.4
10.2
8.8
7.6
8.8
7.4
7.5
11.9
10.7
-3.6
-3.6
11.1
27.6
12.9
4.4
-6.2
15.8
7.7
8.3
8.0
19.3
9.5
4.8
6.3
8.0
8.2
8.2
-3.1
-17.7
-4.4
-10.7
-0.7
4.7
9.9
9.3
13.0
5.0
-----------
9.9
9.8
7.1
7.6
8.9
1990
1991
1992
1993
1994
7.9
11.9
8.6
5.6
6.5
7.4
10.0
11.1
7.8
2.0
3.6
5.2
6.4
4.0
4.7
12.0
10.5
5.1
7.6
3.1
8.7
8.3
7.7
6.5
3.7
8.0
7.5
6.2
7.7
4.1
9.9
6.5
5.4
9.0
3.4
9.9
7.2
2.9
13.2
4.8
5.7
4.0
3.6
7.1
2.1
8.9
6.1
3.1
2.9
0.7
-7.1
16.1
9.1
50.6
-4.9
-6.3
9.9
-10.1
-6.4
-8.4
-----------
8.2
7.3
5.8
6.9
3.4
1995
1996
1997
1998
1999
-2.3
0.3
1.0
16.2
-0.4
6.5
0.5
4.2
2.4
3.0
8.8
-1.7
5.2
9.1
-0.5
-6.8
0.7
12.3
-0.3
8.8
-1.8
2.6
4.9
0.2
10.6
6.9
1.5
5.9
3.7
7.0
5.5
6.4
7.6
6.1
5.2
1.8
0.7
8.0
-1.6
4.7
0.1
0.8
13.3
3.1
8.6
-0.1
1.4
4.8
6.3
5.0
3.5
67.3
-7.8
-3.8
7.8
-13.2
13.8
-3.4
1.9
27.1
-----------
2.9
1.7
6.4
3.4
7.3
2000
2001 f
2002 f
12.6
13.3
3.2
1.0
4.6
2.4
9.4
9.8
4.6
7.0
9.2
5.3
4.9
4.7
4.9
5.5
7.5
5.5
6.6
4.0
8.3
6.9
6.9
3.6
8.0
8.2
6.8
5.8
9.8
4.8
8.1
6.5
6.2
-5.2
9.9
5.2
3.7
-1.1
-0.9
6.0
7.4
5.5
f - Forecast
CIHI 2002
160
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.2.3
Private Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
(percentage)
1975
1976
1977
1978
1979
22.4
27.8
33.6
35.5
34.7
27.0
24.8
23.4
26.3
32.9
21.2
22.8
21.2
21.4
22.3
22.6
21.0
20.7
22.5
25.3
21.2
19.5
18.4
18.1
17.5
24.7
23.9
24.6
26.3
27.9
22.3
20.6
21.5
21.4
23.0
25.5
24.3
24.5
23.2
22.6
23.6
22.5
23.1
23.0
21.8
28.1
28.9
30.4
29.3
28.1
22.1
23.9
24.3
22.3
22.9
24.8
23.8
21.4
20.7
21.0
-----------
23.8
23.0
23.3
23.8
24.1
1980
1981
1982
1983
1984
33.8
33.9
31.1
30.3
25.5
38.5
36.2
33.1
31.0
29.1
22.5
21.1
21.7
21.5
22.1
26.2
26.1
25.6
26.0
27.2
18.5
20.3
19.4
18.9
19.6
27.9
26.7
27.1
27.5
27.7
23.9
24.9
23.7
22.8
23.1
20.5
19.6
18.1
17.4
18.9
22.9
22.2
23.5
19.9
20.4
28.0
25.6
24.4
24.7
26.2
23.5
21.9
18.2
17.5
18.1
21.6
19.7
14.0
13.7
14.4
-----------
24.5
24.1
23.8
23.4
23.9
1985
1986
1987
1988
1989
25.1
20.9
21.3
21.2
20.6
29.2
26.4
26.2
25.7
27.1
23.1
25.7
25.3
26.5
26.8
26.7
26.2
25.6
25.6
25.2
21.0
23.6
23.4
23.2
23.9
27.7
27.1
27.2
26.9
26.7
24.1
24.6
22.7
21.0
21.4
21.8
22.2
22.4
20.1
20.6
20.4
20.5
21.9
24.5
24.7
26.4
26.4
27.0
27.3
27.2
17.1
13.2
12.6
11.4
10.7
14.2
13.0
13.2
12.9
12.6
-----------
24.5
24.9
25.1
25.1
25.3
1990
1991
1992
1993
1994
20.1
21.5
22.5
23.5
24.0
27.3
27.4
29.1
30.0
30.7
26.2
26.3
27.2
28.6
30.0
25.9
27.2
27.5
28.9
29.0
24.4
24.4
25.3
26.3
26.8
27.2
26.9
27.4
29.3
30.2
21.5
22.1
22.3
24.0
24.5
20.4
21.2
21.8
24.9
25.3
24.7
24.8
24.6
26.4
28.2
26.9
26.6
26.1
26.1
25.6
9.4
9.7
10.3
13.3
10.6
11.5
11.5
10.6
9.9
9.3
-----------
25.5
25.5
25.9
27.4
28.0
1995
1996
1997
1998
1999
22.9
22.7
21.9
22.8
20.5
31.7
31.1
32.4
31.4
31.1
31.5
31.2
29.2
29.6
28.4
26.8
26.9
29.6
28.5
28.9
26.5
27.8
27.9
26.4
27.8
32.1
32.5
33.6
33.1
33.5
25.0
26.2
27.1
27.2
25.7
25.3
25.1
25.5
24.1
23.6
29.6
29.2
30.2
29.6
28.8
25.5
25.9
26.5
27.1
26.7
11.1
16.6
16.6
15.4
15.6
8.0
9.3
8.6
7.6
8.9
--------6.3
28.7
29.3
30.0
29.4
29.6
2000
2001 f
2002 f
21.5
22.1
21.9
29.9
28.8
27.2
29.5
30.7
30.5
28.7
28.8
28.3
27.5
26.9
27.3
32.7
33.3
33.4
25.1
24.7
25.0
23.8
23.6
23.4
28.7
27.9
27.9
26.3
26.2
26.0
15.6
14.8
14.5
9.1
9.1
9.0
5.5
5.1
4.9
29.2
29.2
29.3
(annual percentage change)
1975
1976
1977
1978
1979
--23.8
20.9
5.6
-2.0
---8.2
-5.5
12.1
25.2
--7.5
-6.9
0.6
4.4
---7.1
-1.1
8.5
12.2
---8.0
-5.6
-1.8
-3.1
---3.4
2.9
6.8
6.0
---7.7
4.4
-0.7
7.5
---4.8
0.7
-5.0
-2.6
---4.9
2.6
0.0
-5.2
--2.9
5.1
-3.5
-4.1
--8.4
1.7
-8.4
2.9
---3.8
-10.2
-3.1
1.5
-----------
---3.2
1.4
1.9
1.3
1980
1981
1982
1983
1984
-2.7
0.4
-8.2
-2.6
-15.8
17.1
-6.0
-8.5
-6.2
-6.1
0.8
-6.0
2.5
-0.9
2.8
3.7
-0.3
-1.7
1.4
4.8
5.7
9.6
-4.5
-2.2
3.6
0.0
-4.1
1.6
1.2
0.9
4.2
4.3
-5.1
-3.5
1.2
-9.4
-4.4
-7.8
-3.6
8.3
4.8
-3.2
5.9
-15.3
2.5
-0.2
-8.7
-4.9
1.4
5.9
2.3
-6.7
-16.9
-3.6
3.4
2.7
-8.6
-29.3
-1.9
5.3
-----------
1.6
-1.5
-1.4
-1.6
2.3
1985
1986
1987
1988
1989
-1.8
-16.8
2.2
-0.7
-2.9
0.2
-9.5
-0.7
-1.9
5.4
4.8
11.0
-1.5
4.7
1.3
-1.9
-1.9
-2.5
0.1
-1.6
6.9
12.5
-1.0
-0.6
3.1
0.0
-2.0
0.2
-1.2
-0.4
4.2
2.0
-7.4
-7.5
2.0
15.6
1.7
0.9
-10.2
2.7
0.2
0.2
7.0
12.0
0.5
1.1
-0.1
2.4
1.1
-0.4
-5.7
-22.9
-4.4
-9.7
-6.5
-1.7
-8.3
1.3
-1.8
-2.6
-----------
2.3
2.0
0.5
0.1
0.7
1990
1991
1992
1993
1994
-2.2
6.7
4.7
4.6
2.2
0.6
0.3
6.2
3.1
2.5
-2.2
0.1
3.7
4.9
5.1
3.0
4.8
1.1
5.3
0.2
2.1
0.0
3.5
4.0
1.9
1.6
-1.1
2.0
7.0
3.1
0.1
3.1
0.8
7.7
2.0
-1.0
3.6
2.8
14.7
1.6
0.4
0.3
-0.8
7.1
6.9
-1.1
-1.3
-1.7
-0.1
-2.0
-12.0
3.5
6.0
29.0
-20.2
-8.7
0.4
-7.9
-7.1
-5.8
-----------
0.9
-0.1
1.7
5.4
2.3
1995
1996
1997
1998
1999
-4.6
-0.9
-3.6
4.2
-9.9
3.1
-2.0
4.1
-2.9
-1.1
4.8
-0.8
-6.4
1.4
-4.2
-7.5
0.5
10.0
-3.7
1.2
-1.2
5.0
0.6
-5.6
5.5
6.1
1.4
3.5
-1.6
1.3
2.2
4.8
3.4
0.2
-5.4
-0.1
-0.8
1.4
-5.5
-1.8
5.0
-1.3
3.2
-1.7
-2.8
-0.4
1.8
2.4
2.0
-1.4
4.5
50.1
-0.4
-7.0
1.4
-13.7
16.0
-7.8
-11.2
16.6
-----------
2.7
1.9
2.3
-2.0
0.8
2000
2001 f
2002 f
4.7
2.6
-0.7
-3.9
-3.5
-5.5
4.0
4.0
-0.6
-0.5
0.1
-1.5
-1.1
-2.3
1.4
-2.6
2.0
0.2
-2.4
-1.6
1.3
0.9
-0.8
-1.0
-0.3
-2.7
-0.1
-1.4
-0.2
-1.0
-0.2
-5.2
-1.6
2.6
-0.6
-0.6
-13.6
-6.1
-5.1
-1.4
0.1
0.2
f - Forecast
CIHI 2002
161
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.3.1
Public Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
($' 000,000)
1975
1976
1977
1978
1979
205.1
225.9
240.9
266.4
308.9
43.2
47.3
52.6
58.6
64.8
301.4
341.4
369.5
403.0
445.1
214.8
254.3
284.4
313.6
351.3
2,663.2
3,120.1
3,427.9
3,823.4
4,248.1
3,328.5
3,835.4
4,164.6
4,475.1
4,853.4
424.4
499.7
554.1
589.0
634.3
328.6
393.9
443.7
477.8
544.3
757.8
898.5
978.9
1,127.7
1,391.9
995.6
1,158.5
1,276.4
1,446.2
1,645.7
12.4
13.7
14.0
16.6
18.4
26.4
29.7
38.8
44.8
46.6
-----------
9,301.4
10,818.5
11,845.8
13,042.1
14,552.7
1980
1981
1982
1983
1984
349.8
410.4
482.8
539.0
559.4
75.2
87.0
101.9
113.5
121.3
509.4
622.0
719.9
789.0
876.9
415.2
503.5
609.2
662.1
709.6
4,797.5
5,490.7
6,361.9
7,032.2
7,486.1
5,507.2
6,525.4
7,611.1
8,596.5
9,462.5
739.1
865.6
1,017.0
1,141.0
1,224.3
648.5
763.1
925.9
1,038.5
1,112.7
1,660.1
2,042.2
2,564.7
2,901.6
2,996.8
2,073.6
2,553.5
2,929.4
3,131.0
3,272.1
20.0
22.0
30.4
31.4
31.0
47.9
59.2
95.0
106.6
107.6
-----------
16,843.4
19,944.8
23,449.1
26,082.3
27,960.4
1985
588.6
128.3
947.2
752.2
7,927.6
10,443.7
1,310.9
1,195.5
3,239.1
3,413.3
32.9
118.9
---
30,098.4
1986
642.9
138.0
1,023.2
805.3
8,051.3
11,730.2
1,425.8
1,325.9
3,537.9
3,669.4
37.0
145.2
---
32,532.0
1987
693.6
149.7
1,165.5
888.9
8,636.4
13,011.9
1,530.2
1,372.2
3,514.4
3,899.0
39.1
157.4
---
35,058.4
1988
733.8
163.0
1,165.0
961.0
9,428.4
14,497.9
1,634.3
1,468.3
3,645.6
4,242.7
40.6
183.9
---
38,164.3
1989
787.7
174.4
1,281.5
1,047.7
10,108.6
16,093.9
1,773.2
1,629.2
4,031.0
4,736.8
44.2
203.6
---
41,911.9
1990
875.9
186.3
1,377.9
1,136.1
10,814.1
17,332.9
1,951.1
1,792.1
4,326.9
5,390.4
48.5
218.5
---
45,450.5
1991
905.7
203.8
1,455.0
1,186.9
11,815.3
19,156.2
2,006.0
1,828.9
4,557.5
5,967.8
56.5
247.2
---
49,386.7
1992
928.3
209.2
1,480.7
1,233.1
12,234.5
20,058.1
2,100.3
1,819.5
4,846.4
6,478.5
60.4
249.9
---
51,699.0
1993
924.9
218.2
1,448.8
1,236.1
12,459.6
19,880.6
2,089.2
1,727.8
4,800.5
6,870.4
69.0
258.7
---
51,984.0
1994
948.2
217.0
1,416.9
1,272.2
12,674.4
20,068.8
2,115.7
1,778.8
4,527.8
7,330.4
83.2
259.5
---
52,692.8
1995
973.2
222.8
1,442.9
1,323.0
12,708.9
19,943.6
2,179.4
1,820.8
4,283.5
7,569.7
84.2
270.3
---
52,822.2
1996
974.5
233.0
1,440.7
1,325.4
12,254.7
20,088.2
2,185.3
1,862.3
4,466.5
7,688.7
91.0
265.4
---
52,875.7
1997
1,020.9
229.9
1,672.0
1,305.7
12,804.1
20,494.8
2,252.4
1,979.8
4,936.5
7,961.1
85.1
280.9
---
55,023.2
1998
1,107.0
245.8
1,790.4
1,370.3
13,923.6
22,061.8
2,387.5
2,105.8
5,341.2
8,317.0
87.2
324.8
---
59,062.3
1999
1,250.2
258.8
1,904.0
1,470.1
14,353.6
23,437.5
2,719.7
2,258.6
6,152.6
8,973.0
91.1
212.0
123.1
63,204.4
2000
2001 f
2002 f
1,321.1
1,436.7
1,488.6
277.9
307.1
342.6
1,973.5
2,050.5
2,169.4
1,585.1
1,730.2
1,861.1
15,355.8
16,680.3
17,253.9
26,091.3
27,685.6
29,538.7
3,005.4
3,200.7
3,412.8
2,378.9
2,558.1
2,673.4
6,787.7
7,761.2
8,442.7
9,755.8
10,847.9
11,645.6
97.3
108.9
116.8
194.8
217.5
231.4
152.8
165.1
176.7
68,977.5
74,749.9
79,353.7
(annual percentage change)
1975
1976
1977
1978
1979
--10.1
6.6
10.5
16.0
--9.5
11.3
11.4
10.6
--13.3
8.2
9.1
10.5
--18.4
11.8
10.3
12.0
--17.2
9.9
11.5
11.1
--15.2
8.6
7.5
8.5
--17.8
10.9
6.3
7.7
--19.9
12.6
7.7
13.9
--18.6
8.9
15.2
23.4
--16.4
10.2
13.3
13.8
--10.9
1.8
18.5
11.2
--12.7
30.3
15.6
3.9
-----------
--16.3
9.5
10.1
11.6
1980
1981
1982
1983
1984
13.2
17.3
17.6
11.6
3.8
16.0
15.7
17.1
11.3
6.9
14.4
22.1
15.7
9.6
11.1
18.2
21.2
21.0
8.7
7.2
12.9
14.4
15.9
10.5
6.5
13.5
18.5
16.6
12.9
10.1
16.5
17.1
17.5
12.2
7.3
19.2
17.7
21.3
12.2
7.1
19.3
23.0
25.6
13.1
3.3
26.0
23.1
14.7
6.9
4.5
8.3
10.1
38.2
3.3
-1.1
2.9
23.7
60.3
12.2
1.0
-----------
15.7
18.4
17.6
11.2
7.2
1985
1986
1987
1988
1989
5.2
9.2
7.9
5.8
7.4
5.8
7.5
8.5
8.9
7.0
8.0
8.0
13.9
-0.1
10.0
6.0
7.1
10.4
8.1
9.0
5.9
1.6
7.3
9.2
7.2
10.4
12.3
10.9
11.4
11.0
7.1
8.8
7.3
6.8
8.5
7.4
10.9
3.5
7.0
11.0
8.1
9.2
-0.7
3.7
10.6
4.3
7.5
6.3
8.8
11.6
6.1
12.3
5.8
3.8
9.1
10.5
22.2
8.4
16.8
10.7
-----------
7.6
8.1
7.8
8.9
9.8
1990
1991
1992
1993
1994
11.2
3.4
2.5
-0.4
2.5
6.8
9.4
2.7
4.3
-0.6
7.5
5.6
1.8
-2.2
-2.2
8.4
4.5
3.9
0.2
2.9
7.0
9.3
3.5
1.8
1.7
7.7
10.5
4.7
-0.9
0.9
10.0
2.8
4.7
-0.5
1.3
10.0
2.1
-0.5
-5.0
3.0
7.3
5.3
6.3
-0.9
-5.7
13.8
10.7
8.6
6.0
6.7
9.7
16.4
7.0
14.2
20.5
7.3
13.2
1.1
3.5
0.3
-----------
8.4
8.7
4.7
0.6
1.4
1995
1996
1997
1998
1999
2.6
0.1
4.8
8.4
12.9
2.7
4.6
-1.3
6.9
5.3
1.8
-0.1
16.1
7.1
6.3
4.0
0.2
-1.5
4.9
7.3
0.3
-3.6
4.5
8.7
3.1
-0.6
0.7
2.0
7.6
6.2
3.0
0.3
3.1
6.0
13.9
2.4
2.3
6.3
6.4
7.3
-5.4
4.3
10.5
8.2
15.2
3.3
1.6
3.5
4.5
7.9
1.3
8.1
-6.5
2.5
4.4
4.1
-1.8
5.8
15.6
-34.7
-----------
0.2
0.1
4.1
7.3
7.0
5.7
8.7
3.6
7.4
10.5
11.6
3.7
3.9
5.8
7.8
9.2
7.6
7.0
8.6
3.4
11.3
6.1
6.7
10.5
6.5
6.6
5.3
7.5
4.5
10.3
14.3
8.8
8.7
11.2
7.4
6.8
11.9
7.3
-8.1
11.6
6.4
24.1
8.1
7.0
9.1
8.4
6.2
2000
2001 f
2002 f
f - Forecast
CIHI 2002
163
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.3.2
Public Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
($' per capita)
1975
1976
1977
1978
1979
368.79
401.57
426.21
469.61
542.44
366.81
398.40
438.37
481.48
526.92
364.61
408.76
440.06
477.18
524.15
317.30
368.89
408.77
448.30
499.63
420.76
487.77
532.94
593.59
656.85
400.07
455.84
489.62
520.86
560.26
414.03
484.35
533.83
565.69
611.45
358.17
422.78
469.59
501.90
567.20
418.96
480.64
502.58
557.75
663.56
398.32
457.21
496.71
553.24
617.96
566.03
611.85
612.93
698.47
768.97
615.97
671.20
867.88
989.36
1,018.11
-----------
401.92
461.35
499.27
544.24
601.30
1980
1981
1982
1983
1984
610.87
714.09
840.26
929.98
964.24
607.90
703.39
823.01
904.59
958.23
597.33
727.84
837.09
907.78
999.69
588.09
712.80
860.19
925.49
984.10
737.24
838.57
966.96
1,065.11
1,128.93
629.73
740.57
853.04
950.76
1,031.68
714.34
835.22
971.54
1,075.34
1,142.18
670.37
782.01
937.81
1,036.61
1,095.75
757.18
890.16
1,082.97
1,213.87
1,253.85
755.88
904.22
1,019.64
1,077.61
1,110.84
820.91
919.81
1,241.59
1,328.40
1,297.57
1,034.37
1,245.88
1,917.90
2,088.58
2,047.42
-----------
687.03
803.56
933.58
1,028.20
1,091.88
1985
1986
1987
1988
1989
1,016.06
1,115.20
1,205.95
1,276.13
1,366.58
1,005.18
1,074.58
1,164.03
1,260.62
1,340.67
1,070.19
1,150.54
1,304.53
1,298.11
1,417.78
1,039.37
1,110.48
1,221.27
1,315.75
1,425.00
1,189.32
1,200.18
1,273.28
1,378.50
1,458.78
1,123.29
1,242.89
1,349.10
1,472.80
1,591.92
1,211.28
1,306.05
1,393.59
1,482.87
1,606.86
1,165.87
1,288.23
1,328.67
1,428.23
1,598.37
1,347.99
1,455.41
1,443.03
1,485.16
1,615.12
1,147.61
1,221.47
1,278.30
1,361.73
1,480.92
1,351.12
1,510.29
1,521.08
1,524.18
1,631.56
2,185.68
2,655.50
2,859.72
3,301.80
3,570.31
-----------
1,164.68
1,246.41
1,325.46
1,424.13
1,536.01
1990
1991
1992
1993
1994
1,515.22
1,562.84
1,600.01
1,594.13
1,649.55
1,426.78
1,563.74
1,598.35
1,648.92
1,623.08
1,514.65
1,590.06
1,610.56
1,568.45
1,529.57
1,534.98
1,591.97
1,647.51
1,649.21
1,694.12
1,543.89
1,672.43
1,720.07
1,738.91
1,758.55
1,682.87
1,837.06
1,897.55
1,859.66
1,853.50
1,764.76
1,807.86
1,886.93
1,868.13
1,882.51
1,779.42
1,824.04
1,812.31
1,715.90
1,761.77
1,698.39
1,757.91
1,839.69
1,797.46
1,673.92
1,637.73
1,769.08
1,866.85
1,923.67
1,991.01
1,747.70
1,954.17
1,998.73
2,254.94
2,768.24
3,708.73
4,057.16
4,004.30
4,071.51
3,983.42
-----------
1,640.76
1,761.87
1,821.89
1,811.09
1,814.74
1995
1996
1997
1998
1999
1,713.48
1,738.37
1,842.59
2,030.12
2,311.29
1,653.08
1,710.85
1,680.01
1,795.69
1,878.96
1,555.30
1,547.10
1,789.16
1,912.61
2,022.97
1,759.87
1,760.17
1,731.16
1,818.95
1,945.87
1,755.02
1,684.72
1,753.37
1,901.18
1,952.55
1,818.85
1,809.61
1,821.84
1,937.38
2,033.12
1,929.04
1,926.51
1,981.74
2,098.17
2,380.35
1,795.34
1,826.74
1,937.12
2,054.69
2,202.33
1,563.40
1,606.27
1,739.92
1,837.46
2,078.84
2,000.44
1,980.59
2,010.53
2,080.74
2,227.50
2,726.97
2,849.88
2,640.07
2,767.55
2,934.27
4,060.01
3,927.17
4,146.75
4,812.75
5,175.21
--------4,584.73
1,799.50
1,782.01
1,834.89
1,952.58
2,071.64
2000
2001 f
2002 f
2,456.13
2,691.35
2,800.31
2,009.04
2,210.80
2,448.63
2,094.32
2,174.70
2,296.26
2,097.80
2,288.73
2,459.66
2,080.24
2,248.71
2,314.34
2,230.49
2,327.53
2,447.63
2,621.54
2,785.39
2,965.47
2,327.73
2,515.12
2,642.19
2,255.14
2,537.09
2,711.57
2,402.83
2,644.80
2,812.07
3,180.87
3,607.32
3,904.08
4,769.68
5,276.30
5,588.28
5,555.91
5,874.00
6,152.44
2,240.20
2,402.72
2,526.06
(annual percentage change)
1975
1976
1977
1978
1979
--8.9
6.1
10.2
15.5
--8.6
10.0
9.8
9.4
--12.1
7.7
8.4
9.8
--16.3
10.8
9.7
11.4
--15.9
9.3
11.4
10.7
--13.9
7.4
6.4
7.6
--17.0
10.2
6.0
8.1
--18.0
11.1
6.9
13.0
--14.7
4.6
11.0
19.0
--14.8
8.6
11.4
11.7
--8.1
0.2
14.0
10.1
--9.0
29.3
14.0
2.9
-----------
--14.8
8.2
9.0
10.5
1980
1981
1982
1983
1984
12.6
16.9
17.7
10.7
3.7
15.4
15.7
17.0
9.9
5.9
14.0
21.8
15.0
8.4
10.1
17.7
21.2
20.7
7.6
6.3
12.2
13.7
15.3
10.2
6.0
12.4
17.6
15.2
11.5
8.5
16.8
16.9
16.3
10.7
6.2
18.2
16.7
19.9
10.5
5.7
14.1
17.6
21.7
12.1
3.3
22.3
19.6
12.8
5.7
3.1
6.8
12.0
35.0
7.0
-2.3
1.6
20.4
53.9
8.9
-2.0
-----------
14.3
17.0
16.2
10.1
6.2
1985
1986
1987
1988
1989
5.4
9.8
8.1
5.8
7.1
4.9
6.9
8.3
8.3
6.4
7.1
7.5
13.4
-0.5
9.2
5.6
6.8
10.0
7.7
8.3
5.3
0.9
6.1
8.3
5.8
8.9
10.6
8.5
9.2
8.1
6.0
7.8
6.7
6.4
8.4
6.4
10.5
3.1
7.5
11.9
7.5
8.0
-0.9
2.9
8.8
3.3
6.4
4.7
6.5
8.8
4.1
11.8
0.7
0.2
7.0
6.8
21.5
7.7
15.5
8.1
-----------
6.7
7.0
6.3
7.4
7.9
1990
1991
1992
1993
1994
10.9
3.1
2.4
-0.4
3.5
6.4
9.6
2.2
3.2
-1.6
6.8
5.0
1.3
-2.6
-2.5
7.7
3.7
3.5
0.1
2.7
5.8
8.3
2.8
1.1
1.1
5.7
9.2
3.3
-2.0
-0.3
9.8
2.4
4.4
-1.0
0.8
11.3
2.5
-0.6
-5.3
2.7
5.2
3.5
4.7
-2.3
-6.9
10.6
8.0
5.5
3.0
3.5
7.1
11.8
2.3
12.8
22.8
3.9
9.4
-1.3
1.7
-2.2
-----------
6.8
7.4
3.4
-0.6
0.2
1995
1996
1997
1998
1999
3.9
1.5
6.0
10.2
13.8
1.8
3.5
-1.8
6.9
4.6
1.7
-0.5
15.6
6.9
5.8
3.9
0.0
-1.6
5.1
7.0
-0.2
-4.0
4.1
8.4
2.7
-1.9
-0.5
0.7
6.3
4.9
2.5
-0.1
2.9
5.9
13.4
1.9
1.7
6.0
6.1
7.2
-6.6
2.7
8.3
5.6
13.1
0.5
-1.0
1.5
3.5
7.1
-1.5
4.5
-7.4
4.8
6.0
1.9
-3.3
5.6
16.1
7.5
-----------
-0.8
-1.0
3.0
6.4
6.1
6.3
9.6
4.0
6.9
10.0
10.8
3.5
3.8
5.6
7.8
9.1
7.5
6.5
8.1
2.9
9.7
4.4
5.2
10.1
6.3
6.5
5.7
8.1
5.1
8.5
12.5
6.9
7.9
10.1
6.3
8.4
13.4
8.2
-7.8
10.6
5.9
21.2
5.7
4.7
2000
2001 f
2002 f
f - Forecast
8.1
7.3
5.1
CIHI 2002
164
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.3.3
Public Sector Health Expenditure as a Proportion of Total Health Expenditure,
by Province/Territory and Canada, 1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
(percentage)
1975
1976
1977
1978
1979
77.6
72.2
66.4
64.5
65.3
73.0
75.2
76.6
73.7
67.1
78.8
77.2
78.8
78.6
77.7
77.4
79.0
79.3
77.5
74.7
78.8
80.5
81.6
81.9
82.5
75.3
76.1
75.4
73.7
72.1
77.7
79.4
78.5
78.6
77.0
74.5
75.7
75.5
76.8
77.4
76.4
77.5
76.9
77.0
78.2
71.9
71.1
69.6
70.7
71.9
77.9
76.1
75.7
77.7
77.1
75.2
76.2
78.6
79.3
79.0
-----------
76.2
77.0
76.7
76.2
75.9
1980
1981
1982
1983
1984
66.2
66.1
68.9
69.7
74.5
61.5
63.8
66.9
69.0
70.9
77.5
78.9
78.3
78.5
77.9
73.8
73.9
74.4
74.0
72.8
81.5
79.7
80.6
81.1
80.4
72.1
73.3
72.9
72.5
72.3
76.1
75.1
76.3
77.2
76.9
79.5
80.4
81.9
82.6
81.1
77.1
77.8
76.5
80.1
79.6
72.0
74.4
75.6
75.3
73.8
76.5
78.1
81.8
82.5
81.9
78.4
80.3
86.0
86.3
85.6
-----------
75.5
75.9
76.2
76.6
76.1
1985
1986
1987
1988
1989
74.9
79.1
78.7
78.8
79.4
70.8
73.6
73.8
74.3
72.9
76.9
74.3
74.7
73.5
73.2
73.3
73.8
74.4
74.4
74.8
79.0
76.4
76.6
76.8
76.1
72.3
72.9
72.8
73.1
73.3
75.9
75.4
77.3
79.0
78.6
78.2
77.8
77.6
79.9
79.4
79.6
79.5
78.1
75.5
75.3
73.6
73.6
73.0
72.7
72.8
82.9
86.8
87.4
88.6
89.3
85.8
87.0
86.8
87.1
87.4
-----------
75.5
75.1
74.9
74.9
74.7
1990
1991
1992
1993
1994
79.9
78.5
77.5
76.5
76.0
72.7
72.6
70.9
70.0
69.3
73.8
73.7
72.8
71.4
70.0
74.1
72.8
72.5
71.1
71.0
75.6
75.6
74.7
73.7
73.2
72.8
73.1
72.6
70.7
69.8
78.5
77.9
77.7
76.0
75.5
79.6
78.8
78.2
75.1
74.7
75.3
75.2
75.4
73.6
71.8
73.1
73.4
73.9
73.9
74.4
90.6
90.3
89.7
86.7
89.4
88.5
88.5
89.4
90.1
90.7
-----------
74.5
74.5
74.1
72.6
72.0
1995
1996
1997
1998
1999
77.1
77.3
78.1
77.2
79.5
68.3
68.9
67.6
68.6
68.9
68.5
68.8
70.8
70.4
71.6
73.2
73.1
70.4
71.5
71.1
73.5
72.2
72.1
73.6
72.2
67.9
67.5
66.4
66.9
66.5
75.0
73.8
72.9
72.8
74.3
74.7
74.9
74.5
75.9
76.4
70.4
70.8
69.8
70.4
71.2
74.5
74.1
73.5
72.9
73.3
88.9
83.4
83.4
84.6
84.4
92.0
90.7
91.4
92.4
91.1
--------93.7
71.3
70.7
70.0
70.6
70.4
2000
2001 f
2002 f
78.5
77.9
78.1
70.1
71.2
72.8
70.5
69.3
69.5
71.3
71.2
71.7
72.5
73.1
72.7
67.3
66.7
66.6
74.9
75.3
75.0
76.2
76.4
76.6
71.3
72.1
72.1
73.7
73.8
74.0
84.4
85.2
85.5
90.9
90.9
91.0
94.5
94.9
95.1
70.8
70.8
70.7
(annual percentage change)
1975
1976
1977
1978
1979
---6.9
-8.0
-2.8
1.1
--3.0
1.8
-3.7
-9.0
---2.0
2.0
-0.2
-1.2
--2.1
0.3
-2.2
-3.5
--2.1
1.4
0.4
0.7
--1.1
-0.9
-2.2
-2.1
--2.2
-1.1
0.2
-2.0
--1.6
-0.2
1.6
0.8
--1.5
-0.7
0.0
1.6
---1.1
-2.1
1.5
1.7
---2.4
-0.5
2.7
-0.8
--1.3
3.2
0.8
-0.4
-----------
--1.0
-0.4
-0.6
-0.4
1980
1981
1982
1983
1984
1.4
-0.2
4.2
1.2
6.9
-8.4
3.8
4.8
3.1
2.7
-0.2
1.7
-0.7
0.2
-0.8
-1.2
0.1
0.6
-0.5
-1.7
-1.2
-2.2
1.1
0.5
-0.8
0.0
1.6
-0.6
-0.4
-0.3
-1.2
-1.3
1.7
1.1
-0.3
2.8
1.1
1.9
0.8
-1.7
-1.3
1.0
-1.7
4.7
-0.6
0.1
3.4
1.7
-0.5
-1.9
-0.7
2.0
4.7
0.8
-0.7
-0.7
2.4
7.2
0.3
-0.8
-----------
-0.5
0.5
0.4
0.5
-0.7
1985
1986
1987
1988
1989
0.6
5.6
-0.6
0.2
0.8
-0.1
3.9
0.3
0.7
-1.9
-1.4
-3.3
0.5
-1.6
-0.5
0.7
0.7
0.9
0.0
0.6
-1.7
-3.3
0.3
0.2
-0.9
0.0
0.8
-0.1
0.4
0.1
-1.3
-0.6
2.4
2.2
-0.5
-3.6
-0.5
-0.3
2.9
-0.7
0.0
-0.1
-1.8
-3.4
-0.2
-0.4
0.0
-0.8
-0.4
0.2
1.3
4.7
0.7
1.4
0.8
0.3
1.4
-0.2
0.3
0.4
-----------
-0.7
-0.6
-0.2
0.0
-0.2
1990
1991
1992
1993
1994
0.6
-1.7
-1.3
-1.3
-0.7
-0.2
-0.1
-2.3
-1.3
-1.1
0.8
0.0
-1.3
-1.8
-2.0
-1.0
-1.7
-0.4
-2.0
-0.1
-0.7
0.0
-1.1
-1.3
-0.7
-0.6
0.4
-0.7
-2.7
-1.3
0.0
-0.8
-0.2
-2.2
-0.6
0.3
-0.9
-0.7
-4.1
-0.5
-0.1
-0.1
0.3
-2.3
-2.5
0.4
0.5
0.6
0.0
0.7
1.4
-0.4
-0.6
-3.3
3.1
1.3
-0.1
1.0
0.8
0.6
-----------
-0.3
0.0
-0.6
-1.9
-0.9
1995
1996
1997
1998
1999
1.5
0.3
1.1
-1.2
2.9
-1.4
0.9
-1.9
1.4
0.5
-2.1
0.4
2.9
-0.6
1.8
3.1
-0.2
-3.7
1.5
-0.5
0.4
-1.8
-0.2
2.2
-2.0
-2.6
-0.6
-1.7
0.8
-0.6
-0.7
-1.6
-1.2
-0.1
2.0
0.0
0.3
-0.5
1.9
0.6
-2.0
0.6
-1.3
0.7
1.2
0.1
-0.6
-0.8
-0.7
0.5
-0.5
-6.2
0.1
1.4
-0.3
1.4
-1.4
0.8
1.1
-1.4
-----------
-1.0
-0.8
-1.0
0.8
-0.3
2000
2001 f
2002 f
-1.2
-0.7
0.2
1.7
1.5
2.2
-1.6
-1.7
0.3
0.2
0.0
0.6
0.4
0.9
-0.5
1.3
-1.0
-0.1
0.8
0.5
-0.4
-0.3
0.3
0.3
0.1
1.1
0.0
0.5
0.1
0.4
0.0
1.0
0.3
-0.3
0.1
0.1
f - Forecast
0.9
0.4
0.3
0.6
0.0
-0.1
CIHI 2002
165
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.4.1
Provincial/Territorial Government Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
($' 000,000)
1975
199.2
41.5
266.9
203.7
2,531.2
3,143.5
376.7
302.1
694.9
929.3
6.2
15.2
---
8,710.4
1976
219.0
45.4
302.7
242.4
2,972.5
3,612.5
449.3
364.1
811.6
1,084.0
8.8
19.0
---
10,131.2
1977
233.3
50.3
334.6
271.7
3,269.2
3,929.1
497.3
410.8
879.1
1,194.5
10.0
23.4
---
11,103.3
1978
258.2
56.4
370.0
299.1
3,661.8
4,229.4
524.9
445.8
1,020.5
1,365.5
11.4
28.1
---
12,271.1
1979
297.3
62.5
413.1
336.7
4,088.1
4,565.8
569.7
508.5
1,258.2
1,556.9
12.4
27.9
---
13,697.0
1980
336.8
72.6
474.5
395.1
4,607.8
5,164.6
652.8
604.5
1,510.2
1,933.8
13.6
29.3
---
15,795.6
1981
393.4
84.1
572.4
478.2
5,268.2
6,069.9
782.9
709.8
1,871.3
2,377.0
15.0
35.5
---
18,657.7
1982
461.9
98.5
662.7
579.6
6,101.1
7,104.3
915.1
859.0
2,426.3
2,722.5
22.4
51.0
---
22,004.4
1983
515.7
109.6
728.7
627.2
6,740.9
8,019.2
1,021.3
965.6
2,769.4
2,934.4
22.8
57.8
---
24,512.4
1984
534.2
116.7
800.3
671.5
7,165.5
8,828.0
1,102.1
1,022.9
2,843.5
3,077.3
23.5
62.0
---
26,247.4
1985
561.2
123.0
867.5
710.7
7,577.2
9,747.2
1,182.6
1,101.3
3,035.1
3,203.1
24.9
71.9
---
28,205.7
1986
611.2
131.7
917.0
759.2
7,715.3
10,995.1
1,269.6
1,223.4
3,316.8
3,445.8
27.6
91.2
---
30,504.0
1987
660.0
142.5
987.4
837.9
8,257.9
12,203.4
1,364.8
1,264.5
3,308.1
3,663.4
29.4
105.4
---
32,824.6
1988
699.4
153.7
1,071.6
900.8
8,996.9
13,583.0
1,464.7
1,349.3
3,427.8
3,978.9
33.4
147.1
---
35,806.9
1989
751.1
163.1
1,178.9
981.2
9,631.6
15,079.3
1,587.0
1,500.2
3,792.9
4,456.0
36.3
174.6
---
39,332.1
1990
836.0
173.7
1,263.6
1,057.2
10,250.4
16,195.9
1,742.8
1,636.4
4,043.8
5,043.6
38.6
187.9
---
42,469.7
1991
861.0
189.6
1,333.8
1,102.1
11,213.3
17,951.3
1,788.7
1,658.2
4,241.0
5,578.3
45.6
213.9
---
46,176.8
1992
881.0
196.2
1,356.8
1,142.4
11,617.6
18,810.3
1,868.8
1,635.9
4,506.3
6,060.7
49.0
213.6
---
48,338.7
1993
880.9
205.2
1,322.9
1,154.7
11,841.5
18,618.3
1,857.1
1,539.4
4,452.2
6,424.1
58.1
218.4
---
48,573.0
1994
902.6
200.4
1,280.1
1,189.3
12,007.4
18,753.5
1,861.9
1,560.5
4,103.5
6,833.1
71.3
214.0
---
48,977.8
1995
925.5
203.2
1,302.6
1,235.3
12,020.3
18,549.7
1,903.4
1,595.6
3,904.8
7,037.8
68.6
220.6
---
48,967.1
1996
926.0
213.2
1,317.7
1,234.5
11,587.3
18,696.6
1,922.8
1,637.4
4,091.3
7,186.1
67.3
215.3
---
49,095.5
1997
968.2
213.9
1,552.0
1,214.0
11,901.7
19,065.6
1,976.6
1,749.2
4,527.6
7,434.9
69.2
231.1
---
50,904.0
1998
1,049.6
229.1
1,656.2
1,269.2
12,925.1
20,123.4
2,102.5
1,856.1
4,883.3
7,756.5
74.1
273.2
---
54,198.2
1999
1,187.5
240.6
1,748.8
1,369.1
13,219.7
21,584.8
2,394.9
1,995.6
5,635.2
8,355.3
77.8
176.9
105.0
58,091.4
2000
2001 f
2002 f
1,249.1
1,361.6
1,410.6
258.5
286.9
322.1
1,787.2
1,854.2
1,962.5
1,469.4
1,606.2
1,727.4
14,131.2
15,405.7
15,922.2
24,108.7
25,528.6
27,275.9
2,628.7
2,799.4
2,982.7
2,092.9
2,248.2
2,357.4
6,208.9
7,129.8
7,778.2
9,119.8
10,169.3
10,942.7
82.3
92.8
100.3
158.2
179.7
193.2
131.0
143.3
154.5
63,425.8
68,805.6
73,129.8
(annual percentage change)
1975
1976
1977
1978
1979
--9.9
6.5
10.7
15.1
--9.4
10.8
12.1
10.9
--13.4
10.5
10.6
11.7
--19.0
12.1
10.1
12.6
--17.4
10.0
12.0
11.6
--14.9
8.8
7.6
8.0
--19.3
10.7
5.6
8.5
--20.5
12.8
8.5
14.0
--16.8
8.3
16.1
23.3
--16.6
10.2
14.3
14.0
--42.9
13.3
14.1
8.5
--24.3
23.4
19.9
-0.5
-----------
--16.3
9.6
10.5
11.6
1980
1981
1982
1983
1984
13.3
16.8
17.4
11.7
3.6
16.1
15.8
17.1
11.3
6.5
14.9
20.6
15.8
10.0
9.8
17.3
21.0
21.2
8.2
7.1
12.7
14.3
15.8
10.5
6.3
13.1
17.5
17.0
12.9
10.1
14.6
19.9
16.9
11.6
7.9
18.9
17.4
21.0
12.4
5.9
20.0
23.9
29.7
14.1
2.7
24.2
22.9
14.5
7.8
4.9
10.0
10.4
49.2
1.8
3.1
4.9
21.2
43.8
13.2
7.3
-----------
15.3
18.1
17.9
11.4
7.1
1985
1986
1987
1988
1989
5.1
8.9
8.0
6.0
7.4
5.4
7.1
8.2
7.9
6.1
8.4
5.7
7.7
8.5
10.0
5.8
6.8
10.4
7.5
8.9
5.7
1.8
7.0
8.9
7.1
10.4
12.8
11.0
11.3
11.0
7.3
7.4
7.5
7.3
8.3
7.7
11.1
3.4
6.7
11.2
6.7
9.3
-0.3
3.6
10.7
4.1
7.6
6.3
8.6
12.0
5.7
10.9
6.6
13.8
8.5
16.0
26.9
15.7
39.5
18.7
-----------
7.5
8.1
7.6
9.1
9.8
1990
1991
1992
1993
1994
11.3
3.0
2.3
0.0
2.5
6.5
9.2
3.5
4.6
-2.3
7.2
5.6
1.7
-2.5
-3.2
7.7
4.2
3.7
1.1
3.0
6.4
9.4
3.6
1.9
1.4
7.4
10.8
4.8
-1.0
0.7
9.8
2.6
4.5
-0.6
0.3
9.1
1.3
-1.3
-5.9
1.4
6.6
4.9
6.3
-1.2
-7.8
13.2
10.6
8.6
6.0
6.4
6.6
18.1
7.3
18.6
22.8
7.6
13.8
-0.1
2.2
-2.0
-----------
8.0
8.7
4.7
0.5
0.8
1995
1996
1997
1998
1999
2.5
0.1
4.6
8.4
13.1
1.4
4.9
0.3
7.1
5.0
1.8
1.2
17.8
6.7
5.6
3.9
-0.1
-1.7
4.5
7.9
0.1
-3.6
2.7
8.6
2.3
-1.1
0.8
2.0
5.5
7.3
2.2
1.0
2.8
6.4
13.9
2.2
2.6
6.8
6.1
7.5
-4.8
4.8
10.7
7.9
15.4
3.0
2.1
3.5
4.3
7.7
-3.8
-1.8
2.8
7.0
5.0
3.1
-2.4
7.4
18.2
-35.3
-----------
0.0
0.3
3.7
6.5
7.2
5.2
9.0
3.6
7.4
11.0
12.3
2.2
3.7
5.8
7.3
9.3
7.5
6.9
9.0
3.4
11.7
5.9
6.8
9.8
6.5
6.5
4.9
7.4
4.9
10.2
14.8
9.1
9.1
11.5
7.6
5.8
12.8
8.1
-10.6
13.6
7.5
24.7
9.4
7.8
9.2
8.5
6.3
2000
2001 f
2002 f
f - Forecast
CIHI 2002
167
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.4.2
Provincial/Territorial Government Sector Health Expenditure, by Province/Territory and Canada
1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
($' per capita)
1975
1976
1977
1978
1979
358.08
389.21
412.72
455.28
521.98
352.59
382.69
419.05
463.11
508.31
322.89
362.38
398.43
438.08
486.44
300.87
351.60
390.52
427.54
478.78
399.90
464.69
508.27
568.50
632.12
377.83
429.35
461.94
492.26
527.07
367.52
435.49
479.06
504.13
549.18
329.31
390.81
434.76
468.36
529.89
384.21
434.15
451.34
504.73
599.82
371.78
427.82
464.84
522.38
584.63
281.70
392.62
437.44
480.28
515.47
355.89
427.62
523.77
619.68
610.55
-----------
376.38
432.04
467.97
512.06
565.94
1980
1981
1982
1983
1984
588.28
684.49
803.88
889.85
920.67
586.87
679.49
795.17
873.47
921.68
556.31
669.77
770.56
838.35
912.44
559.50
677.01
818.37
876.77
931.38
708.09
804.58
927.32
1,020.99
1,080.58
590.55
688.88
796.24
886.91
962.50
630.93
755.38
874.17
962.49
1,028.22
624.89
727.33
870.12
963.80
1,007.34
688.81
815.66
1,024.50
1,158.55
1,189.70
704.94
841.72
947.65
1,009.96
1,044.69
559.01
628.28
915.36
965.29
983.00
632.71
746.47
1,030.57
1,132.08
1,178.74
-----------
644.29
751.71
876.06
966.31
1,024.99
1985
1986
1987
1988
1989
968.84
1,060.20
1,147.53
1,216.33
1,303.05
963.61
1,025.65
1,107.97
1,189.15
1,253.92
980.12
1,031.12
1,105.10
1,194.14
1,304.21
982.04
1,046.95
1,151.22
1,233.39
1,334.52
1,136.75
1,150.11
1,217.47
1,315.42
1,389.94
1,048.37
1,165.01
1,265.27
1,379.86
1,491.56
1,092.73
1,163.02
1,242.89
1,329.02
1,438.08
1,073.94
1,188.66
1,224.33
1,312.50
1,471.85
1,263.06
1,364.48
1,358.32
1,396.41
1,519.72
1,076.95
1,147.04
1,201.07
1,277.08
1,393.12
1,020.17
1,125.67
1,142.29
1,255.18
1,337.02
1,320.82
1,666.68
1,915.59
2,641.44
3,061.70
-----------
1,091.44
1,168.71
1,241.01
1,336.16
1,441.46
1990
1991
1992
1993
1994
1,446.15
1,485.74
1,518.59
1,518.20
1,570.26
1,330.33
1,455.03
1,499.30
1,550.88
1,499.32
1,388.99
1,457.61
1,475.80
1,432.20
1,381.96
1,428.35
1,478.23
1,526.35
1,540.63
1,583.73
1,463.41
1,587.22
1,633.33
1,652.64
1,666.00
1,572.49
1,721.51
1,779.52
1,741.58
1,732.03
1,576.29
1,612.07
1,678.94
1,660.59
1,656.69
1,624.80
1,653.78
1,629.44
1,528.73
1,545.55
1,587.27
1,635.83
1,710.57
1,667.05
1,517.07
1,532.37
1,653.60
1,746.46
1,798.71
1,855.95
1,391.06
1,578.16
1,619.07
1,897.36
2,373.79
3,189.78
3,510.43
3,423.11
3,437.35
3,284.08
-----------
1,533.16
1,647.36
1,703.47
1,692.25
1,686.80
1995
1996
1997
1998
1999
1,629.49
1,651.87
1,747.43
1,924.80
2,195.49
1,507.22
1,565.40
1,563.03
1,673.63
1,746.61
1,404.09
1,415.02
1,660.70
1,769.29
1,858.13
1,643.11
1,639.44
1,609.54
1,684.73
1,812.20
1,659.93
1,592.98
1,629.80
1,764.85
1,798.31
1,691.73
1,684.24
1,694.80
1,767.16
1,872.40
1,684.73
1,695.05
1,739.04
1,847.72
2,096.14
1,573.28
1,606.18
1,711.50
1,811.04
1,945.87
1,425.18
1,471.35
1,595.81
1,679.93
1,904.02
1,859.88
1,851.11
1,877.65
1,940.52
2,074.17
2,220.34
2,108.74
2,147.63
2,349.43
2,504.94
3,313.42
3,185.91
3,411.81
4,048.46
4,317.27
--------3,910.92
1,668.17
1,654.61
1,697.53
1,791.77
1,904.05
2000
2001 f
2002 f
2,322.25
2,550.62
2,653.51
1,868.35
2,065.53
2,302.29
1,896.64
1,966.54
2,077.24
1,944.60
2,124.68
2,282.91
1,914.34
2,076.87
2,135.72
2,061.00
2,146.18
2,260.13
2,292.94
2,436.15
2,591.73
2,047.95
2,210.47
2,329.90
2,062.85
2,330.68
2,498.15
2,246.18
2,479.37
2,642.36
2,689.45
3,074.64
3,352.15
3,871.65
4,358.14
4,665.41
4,762.17
5,098.08
5,381.74
2,059.89
2,211.65
2,327.94
(annual percentage change)
1975
1976
1977
1978
1979
--8.7
6.0
10.3
14.6
--8.5
9.5
10.5
9.8
--12.2
9.9
10.0
11.0
--16.9
11.1
9.5
12.0
--16.2
9.4
11.9
11.2
--13.6
7.6
6.6
7.1
--18.5
10.0
5.2
8.9
--18.7
11.2
7.7
13.1
--13.0
4.0
11.8
18.8
--15.1
8.7
12.4
11.9
--39.4
11.4
9.8
7.3
--20.2
22.5
18.3
-1.5
-----------
--14.8
8.3
9.4
10.5
1980
1981
1982
1983
1984
12.7
16.4
17.4
10.7
3.5
15.5
15.8
17.0
9.8
5.5
14.4
20.4
15.0
8.8
8.8
16.9
21.0
20.9
7.1
6.2
12.0
13.6
15.3
10.1
5.8
12.0
16.7
15.6
11.4
8.5
14.9
19.7
15.7
10.1
6.8
17.9
16.4
19.6
10.8
4.5
14.8
18.4
25.6
13.1
2.7
20.6
19.4
12.6
6.6
3.4
8.4
12.4
45.7
5.5
1.8
3.6
18.0
38.1
9.8
4.1
-----------
13.8
16.7
16.5
10.3
6.1
1985
1986
1987
1988
1989
5.2
9.4
8.2
6.0
7.1
4.5
6.4
8.0
7.3
5.4
7.4
5.2
7.2
8.1
9.2
5.4
6.6
10.0
7.1
8.2
5.2
1.2
5.9
8.0
5.7
8.9
11.1
8.6
9.1
8.1
6.3
6.4
6.9
6.9
8.2
6.6
10.7
3.0
7.2
12.1
6.2
8.0
-0.5
2.8
8.8
3.1
6.5
4.7
6.3
9.1
3.8
10.3
1.5
9.9
6.5
12.1
26.2
14.9
37.9
15.9
-----------
6.5
7.1
6.2
7.7
7.9
1990
1991
1992
1993
1994
11.0
2.7
2.2
0.0
3.4
6.1
9.4
3.0
3.4
-3.3
6.5
4.9
1.2
-3.0
-3.5
7.0
3.5
3.3
0.9
2.8
5.3
8.5
2.9
1.2
0.8
5.4
9.5
3.4
-2.1
-0.5
9.6
2.3
4.1
-1.1
-0.2
10.4
1.8
-1.5
-6.2
1.1
4.4
3.1
4.6
-2.5
-9.0
10.0
7.9
5.6
3.0
3.2
4.0
13.4
2.6
17.2
25.1
4.2
10.1
-2.5
0.4
-4.5
-----------
6.4
7.4
3.4
-0.7
-0.3
1995
1996
1997
1998
1999
3.8
1.4
5.8
10.2
14.1
0.5
3.9
-0.2
7.1
4.4
1.6
0.8
17.4
6.5
5.0
3.7
-0.2
-1.8
4.7
7.6
-0.4
-4.0
2.3
8.3
1.9
-2.3
-0.4
0.6
4.3
6.0
1.7
0.6
2.6
6.2
13.4
1.8
2.1
6.6
5.8
7.4
-6.1
3.2
8.5
5.3
13.3
0.2
-0.5
1.4
3.3
6.9
-6.5
-5.0
1.8
9.4
6.6
0.9
-3.8
7.1
18.7
6.6
-----------
-1.1
-0.8
2.6
5.6
6.3
5.8
9.8
4.0
7.0
10.6
11.5
2.1
3.7
5.6
7.3
9.3
7.4
6.5
8.5
2.8
10.1
4.1
5.3
9.4
6.2
6.4
5.2
7.9
5.4
8.3
13.0
7.2
8.3
10.4
6.6
7.4
14.3
9.0
-10.3
12.6
7.1
2000
2001 f
2002 f
f - Forecast
21.8
7.1
5.6
8.2
7.4
5.3
CIHI 2002
168
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table B.4.3
Provincial/Territorial Government Sector Health Expenditure as a Proportion of
Total Health Expenditure, by Province/Territory and Canada, 1975 to 2002 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Year
Man.
Sask.
Alta.
B.C.
Y.T.
N.W.T
Nun.
Canada
Average
(percentage)
1975
1976
1977
1978
1979
75.3
70.0
64.3
62.6
62.8
70.2
72.2
73.2
70.9
64.7
69.8
68.4
71.3
72.2
72.1
73.4
75.3
75.7
73.9
71.6
74.9
76.7
77.8
78.5
79.4
71.1
71.7
71.1
69.7
67.9
69.0
71.4
70.4
70.1
69.2
68.5
70.0
69.9
71.6
72.3
70.0
70.0
69.1
69.6
70.6
67.1
66.5
65.2
66.7
68.0
38.8
48.8
54.0
53.4
51.7
43.5
48.5
47.4
49.7
47.4
-----------
71.4
72.1
71.9
71.7
71.4
1980
1981
1982
1983
1984
63.7
63.3
65.9
66.7
71.1
59.4
61.7
64.6
66.6
68.2
72.2
72.6
72.1
72.5
71.1
70.2
70.2
70.7
70.1
68.9
78.3
76.5
77.3
77.7
76.9
67.7
68.2
68.0
67.7
67.5
67.2
67.9
68.7
69.1
69.2
74.1
74.8
76.0
76.8
74.6
70.1
71.3
72.4
76.5
75.5
67.1
69.2
70.3
70.6
69.4
52.1
53.3
60.3
59.9
62.0
48.0
48.1
46.2
46.8
49.3
-----------
70.8
71.0
71.5
72.0
71.4
1985
1986
1987
1988
1989
71.4
75.2
74.9
75.1
75.7
67.9
70.2
70.2
70.1
68.2
70.4
66.6
63.3
67.6
67.3
69.3
69.6
70.2
69.8
70.1
75.5
73.2
73.3
73.3
72.5
67.5
68.3
68.3
68.5
68.6
68.5
67.2
68.9
70.8
70.3
72.0
71.8
71.5
73.4
73.1
74.6
74.6
73.5
71.0
70.9
69.0
69.1
68.6
68.1
68.5
62.6
64.7
65.6
73.0
73.2
51.9
54.6
58.2
69.7
75.0
-----------
70.8
70.4
70.2
70.3
70.1
1990
1991
1992
1993
1994
76.2
74.7
73.6
72.9
72.3
67.8
67.6
66.5
65.8
64.0
67.6
67.6
66.7
65.2
63.2
68.9
67.6
67.2
66.4
66.4
71.6
71.7
70.9
70.1
69.4
68.1
68.5
68.1
66.2
65.2
70.1
69.4
69.1
67.5
66.4
72.7
71.5
70.4
66.9
65.5
70.3
70.0
70.1
68.3
65.1
68.4
68.6
69.1
69.1
69.4
72.1
72.9
72.7
73.0
76.7
76.1
76.5
76.4
76.1
74.8
-----------
69.6
69.7
69.2
67.9
66.9
1995
1996
1997
1998
1999
73.3
73.4
74.1
73.2
75.5
62.3
63.1
62.9
63.9
64.1
61.9
62.9
65.7
65.1
65.8
68.3
68.1
65.4
66.2
66.2
69.6
68.3
67.0
68.4
66.5
63.2
62.8
61.7
61.0
61.2
65.5
64.9
64.0
64.1
65.4
65.5
65.9
65.9
66.9
67.5
64.2
64.8
64.1
64.3
65.2
69.3
69.2
68.6
68.0
68.3
72.4
61.7
67.9
71.8
72.0
75.1
73.6
75.2
77.7
76.0
--------79.9
66.1
65.7
64.8
64.8
64.7
2000
2001 f
2002 f
74.2
73.9
74.0
65.2
66.5
68.4
63.8
62.7
62.9
66.1
66.1
66.5
66.7
67.5
67.1
62.2
61.5
61.5
65.5
65.9
65.5
67.0
67.1
67.6
65.2
66.2
66.4
68.9
69.1
69.6
71.4
72.6
73.4
73.8
75.1
76.0
81.0
82.3
83.2
65.1
65.2
65.2
(annual percentage change)
1975
1976
1977
1978
1979
---7.0
-8.1
-2.7
0.4
--3.0
1.3
-3.1
-8.7
---1.9
4.2
1.2
-0.1
--2.6
0.5
-2.4
-3.1
--2.4
1.5
0.8
1.2
--0.8
-0.8
-2.1
-2.6
--3.5
-1.3
-0.5
-1.3
--2.2
-0.1
2.4
0.9
--0.0
-1.3
0.8
1.4
---0.9
-2.0
2.4
1.9
--25.9
10.6
-1.1
-3.3
--11.7
-2.3
4.7
-4.6
-----------
--1.0
-0.3
-0.2
-0.4
1980
1981
1982
1983
1984
1.5
-0.7
4.0
1.2
6.7
-8.3
3.9
4.8
3.0
2.4
0.1
0.5
-0.6
0.6
-1.9
-1.9
-0.1
0.8
-0.9
-1.8
-1.4
-2.3
1.1
0.5
-1.0
-0.3
0.8
-0.2
-0.5
-0.3
-2.9
1.0
1.2
0.5
0.2
2.5
0.9
1.6
1.0
-2.8
-0.7
1.7
1.5
5.6
-1.2
-1.3
3.2
1.5
0.4
-1.6
0.9
2.4
13.0
-0.6
3.5
1.3
0.3
-3.8
1.2
5.3
-----------
-0.9
0.2
0.8
0.7
-0.8
1985
1986
1987
1988
1989
0.5
5.3
-0.5
0.4
0.8
-0.4
3.5
0.0
-0.2
-2.7
-1.0
-5.4
-5.0
6.9
-0.5
0.6
0.5
0.9
-0.6
0.5
-1.8
-3.1
0.1
0.0
-1.1
0.0
1.2
0.0
0.3
0.1
-1.1
-1.9
2.6
2.7
-0.7
-3.4
-0.3
-0.4
2.7
-0.5
-1.3
0.0
-1.4
-3.5
-0.1
-0.6
0.1
-0.8
-0.6
0.5
0.9
3.4
1.4
11.2
0.3
5.3
5.3
6.5
19.8
7.6
-----------
-0.9
-0.6
-0.3
0.2
-0.2
1990
1991
1992
1993
1994
0.7
-2.1
-1.5
-1.0
-0.7
-0.5
-0.3
-1.5
-1.0
-2.8
0.5
-0.1
-1.3
-2.2
-3.1
-1.6
-1.9
-0.6
-1.2
0.0
-1.2
0.1
-1.1
-1.3
-1.0
-0.8
0.7
-0.7
-2.8
-1.5
-0.2
-1.0
-0.4
-2.3
-1.6
-0.6
-1.6
-1.6
-4.9
-2.0
-0.8
-0.5
0.2
-2.6
-4.7
-0.1
0.4
0.7
0.0
0.4
-1.5
1.1
-0.3
0.4
5.1
1.6
0.5
-0.2
-0.4
-1.7
-----------
-0.7
0.1
-0.6
-2.0
-1.4
1995
1996
1997
1998
1999
1.4
0.2
0.9
-1.2
3.1
-2.7
1.3
-0.2
1.6
0.2
-2.1
1.7
4.4
-0.9
1.1
2.9
-0.4
-3.8
1.2
0.1
0.3
-1.8
-1.9
2.0
-2.8
-3.1
-0.6
-1.7
-1.1
0.3
-1.5
-0.9
-1.5
0.3
2.0
-0.1
0.6
0.0
1.6
0.8
-1.4
1.1
-1.2
0.4
1.4
-0.1
-0.1
-0.9
-0.8
0.4
-5.6
-14.8
10.0
5.8
0.3
0.4
-2.0
2.2
3.3
-2.2
-----------
-1.3
-0.6
-1.3
0.0
-0.2
2000
2001 f
2002 f
-1.7
-0.5
0.2
1.8
2.0
2.9
-3.0
-1.8
0.3
-0.3
0.1
0.6
0.3
1.2
-0.6
1.6
-1.2
0.0
0.1
0.5
-0.5
-0.7
0.2
0.7
0.0
1.5
0.3
0.9
0.4
0.6
-0.9
1.8
1.0
-2.9
1.8
1.1
f - Forecast
1.4
1.6
1.1
0.6
0.1
0.0
CIHI 2002
169
Series E
Provincial/Territorial Government Health
Expenditure, by Age and Sex, by
Province/Territory and Canada
(Selected Tables)
171
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table E.1.1
Estimate of Total Provincial/Territorial Government Health Expenditures by Age and Sex,
by Province/Territory and Canada, 1998 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Age
Groups
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
($' 000,000)
Both Sexes
23.6
18.6
48.2
268.1
239.4
163.2
183.4
105.0
6.0
4.8
11.5
57.2
45.7
34.8
43.0
26.1
51.8
29.3
64.7
386.3
342.7
280.3
312.9
188.2
34.1
27.6
55.9
313.6
266.8
206.7
225.8
138.7
372.9
256.9
554.9
3,165.7
2,826.2
2,370.2
2,202.9
1,175.4
661.6
445.0
811.6
5,291.5
4,193.7
3,410.3
3,369.9
1,939.8
68.1
42.9
93.6
523.9
404.6
297.2
393.0
279.2
49.5
53.0
115.3
506.2
333.7
251.3
312.2
234.8
180.6
125.3
281.4
1,516.4
969.2
675.3
724.3
410.9
193.7
159.2
356.6
2,179.3
1,535.4
1,125.0
1,337.0
870.3
2.4
2.8
6.7
29.5
16.0
7.8
5.2
3.6
19.9
16.8
30.6
121.5
44.3
18.8
14.9
6.3
-----------------
1,664.3
1,182.1
2,431.0
14,359.1
11,217.7
8,841.1
9,124.5
5,378.4
1,049.6
229.1
1,656.2
1,269.2
12,925.1
20,123.4
2,102.5
1,856.1
4,883.3
7,756.5
74.1
273.2
---
54,198.2
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
10.9
8.3
23.0
164.7
119.9
77.6
104.2
74.8
2.9
2.1
5.6
35.7
23.3
17.8
24.7
18.5
22.3
13.2
30.6
243.9
171.1
138.9
185.4
135.4
14.7
12.3
26.3
194.4
134.5
103.9
130.7
99.6
169.7
119.5
266.2
1,883.8
1,402.1
1,186.8
1,300.4
851.3
306.1
218.3
383.8
3,334.4
2,141.6
1,695.3
1,946.9
1,408.6
30.1
20.1
44.7
311.3
205.5
148.4
233.0
201.3
22.8
24.6
55.6
297.5
168.6
124.6
178.3
160.5
81.6
58.2
134.0
913.0
497.4
329.5
421.9
287.6
88.5
71.6
167.8
1,307.9
769.9
544.4
773.4
618.5
1.1
1.3
3.2
17.6
8.1
3.0
3.2
2.8
9.1
7.8
14.9
74.4
22.5
8.4
8.9
4.0
-----------------
759.7
557.4
1,155.7
8,778.7
5,664.6
4,378.7
5,310.8
3,862.9
Total
583.5
130.6
940.9
716.6
7,179.9
11,434.9
1,194.4
1,032.4
2,723.1
4,342.0
40.3
150.0
---
30,468.5
38.1
22.8
48.8
212.7
199.1
148.8
160.0
77.9
26.8
28.4
59.8
208.7
165.1
126.7
133.9
74.4
99.0
67.1
147.4
603.3
471.9
345.8
302.4
123.3
105.2
87.6
188.8
871.4
765.5
580.7
563.6
251.8
1.3
1.5
3.5
11.9
7.9
4.8
2.0
0.8
10.8
9.0
15.7
47.1
21.8
10.4
6.0
2.3
-----------------
904.6
624.8
1,275.3
5,580.4
5,553.1
4,462.4
3,813.8
1,515.5
908.1
823.7
2,160.2
3,414.5
33.7
123.2
---
23,729.7
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
12.7
10.3
25.1
103.5
119.5
85.6
79.2
30.2
3.1
2.7
5.9
21.4
22.4
17.1
18.3
7.6
29.6
16.1
34.1
142.4
171.5
141.4
127.6
52.7
19.4
15.3
29.5
119.1
132.2
102.8
95.1
39.1
203.2
137.4
288.7
1,281.8
1,424.1
1,183.4
902.5
324.1
355.5
226.7
427.9
1,957.1
2,052.0
1,715.0
1,423.1
531.2
Total
466.1
98.5
715.3
552.6
5,745.2
8,688.5
($' per capita)
Both Sexes
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
4,492.44 3,970.84 5,288.02 4,297.13 4,839.79 4,981.24 4,758.31 3,880.72 4,767.96 4,488.98 6,131.94 14,880.29
812.90
700.32
675.32
805.24
731.35
748.88
679.53
941.88
783.83
829.81 1,560.25 2,841.95
664.66
577.92
520.50
568.87
599.81
524.34
564.01
726.19
647.64
689.78 1,361.52 2,162.40
1,044.59
948.37
916.98
910.52
950.76 1,018.53 1,043.86 1,131.24 1,078.67 1,190.35 1,856.24 3,585.49
1,891.95 1,506.41 1,598.63 1,553.08 1,632.40 1,676.95 1,703.57 1,660.64 1,665.49 1,697.80 2,288.80 4,446.22
4,698.78 3,704.07 4,262.96 3,942.24 4,406.69 4,163.64 3,677.06 3,317.79 4,085.96 3,972.26 7,438.82 12,637.93
8,758.38 6,812.36 7,217.55 6,727.94 7,673.36 7,326.31 7,125.95 5,854.54 7,780.43 7,653.79 13,490.97 26,327.17
18,296.30 11,643.19 13,538.25 12,849.27 13,939.57 14,118.62 14,595.55 12,023.89 14,376.42 16,694.86 35,762.04 35,029.53
1,924.80
1,673.63
1,769.29
1,684.73
1,764.85
1,767.16
1,847.72
1,811.04
1,679.93
1,940.52
2,349.43
4,048.46
--- 4,835.18
--771.80
--595.36
--- 1,037.27
--- 1,670.09
--- 4,156.86
--- 7,427.77
--- 14,379.08
---
1,791.77
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
4,241.78 3,822.48 4,652.84 3,849.72 4,524.34 4,720.96 4,316.20 3,587.89 4,373.65 4,185.71 5,838.68 13,767.67
745.98
649.85
625.80
743.96
695.16
753.74
652.75
892.38
752.21
770.33 1,525.11 2,733.13
650.80
573.57
505.12
549.81
589.08
509.66
553.87
717.27
633.77
666.67 1,366.20 2,141.80
1,281.46 1,186.38 1,156.67 1,144.90 1,152.34 1,290.01 1,264.16 1,351.02 1,330.90 1,442.91 2,248.52 4,583.89
1,903.97 1,527.00 1,585.72 1,563.35 1,597.00 1,690.00 1,724.36 1,685.69 1,735.65 1,706.29 2,550.07 4,984.01
4,294.02 3,567.11 3,910.31 3,675.19 4,016.97 3,862.40 3,421.11 3,133.72 3,844.52 3,687.68 6,517.23 11,853.31
8,587.77 6,415.39 7,002.73 6,482.79 7,240.05 7,033.96 7,004.47 5,721.95 7,658.30 7,521.72 14,915.87 33,730.35
19,112.60 12,013.11 13,720.24 13,273.38 13,871.03 14,550.37 15,349.72 12,476.09 14,826.63 17,657.61 44,243.64 42,230.67
2,123.78
1,877.46
1,972.03
1,885.35
1,935.00
1,981.11
2,081.65
2,003.23
1,890.78
2,161.35
2,663.05
4,648.68
--- 4,515.42
--747.09
--581.01
--- 1,283.09
--- 1,674.89
--- 3,844.73
--- 7,159.27
--- 14,768.22
---
1,995.37
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
4,732.18 4,121.16 5,894.09 4,713.82 5,139.07 5,229.50 5,177.21 4,170.49 5,150.52 4,780.43 6,402.21 15,961.77
876.57
746.01
722.42
862.36
766.03
744.25
705.09
989.42
813.51
885.75 1,592.22 2,942.75
677.89
582.12
535.09
587.02
610.06
538.25
573.62
734.69
660.78
711.71 1,357.20 2,182.26
807.12
710.71
676.69
682.51
756.33
749.72
831.71
918.33
838.27
942.68 1,474.89 2,667.36
1,880.04 1,485.57 1,611.71 1,542.78 1,668.83 1,663.54 1,682.62 1,635.82 1,597.43 1,689.34 2,073.05 3,999.76
5,138.07 3,858.23 4,677.57 4,254.82 4,881.66 4,511.46 3,973.69 3,521.31 4,346.03 4,282.03 8,156.82 13,355.07
8,993.45 7,432.15 7,554.26 7,096.60 8,397.52 7,768.00 7,310.53 6,040.90 7,957.45 7,842.77 11,691.09 19,880.04
16,546.14 10,830.43 13,092.37 11,882.40 14,122.86 13,088.70 12,952.21 11,151.78 13,425.33 14,723.43 21,700.44 27,074.77
1,722.74
1,463.00
1,558.55
1,480.45
1,590.11
1,547.25
1,609.79
1,616.65
1,472.89
1,717.39
2,059.70
3,498.40
--- 5,140.94
--795.26
--608.99
--797.05
--- 1,665.23
--- 4,516.66
--- 7,837.07
--- 13,474.16
---
1,584.22
CIHI 2002
Note: See methodology for age-sex distribution in the Methodological Notes section of this report.
173
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table E.1.2
Estimate of Total Provincial/Territorial Government Health Expenditures by Age and Sex,
by Province/Territory and Canada, 1999 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Age
Groups
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
($' 000,000)
Both Sexes
26.4
23.1
61.9
316.4
272.1
171.5
194.7
121.4
5.7
4.6
11.6
57.3
47.8
36.3
46.6
30.6
49.3
29.7
64.0
404.2
359.3
292.2
336.2
213.9
35.2
27.8
58.4
334.0
299.0
219.0
246.1
149.7
369.1
240.3
551.0
3,154.3
2,940.9
2,400.8
2,312.3
1,251.0
672.6
466.4
902.1
5,687.4
4,555.4
3,581.0
3,624.4
2,095.4
70.1
51.6
120.1
622.3
479.0
324.6
417.3
309.9
54.8
53.6
125.6
541.8
364.6
265.3
337.7
252.2
194.3
143.9
339.8
1,761.2
1,146.7
765.3
795.4
488.6
188.8
160.4
380.4
2,302.4
1,686.6
1,187.3
1,444.9
1,004.5
2.2
2.7
6.9
30.2
17.7
8.0
6.3
3.8
10.8
8.1
15.8
77.0
31.8
15.5
11.3
6.6
8.2
8.2
15.6
47.4
16.3
6.2
2.6
0.6
1,687.6
1,220.5
2,653.1
15,335.9
12,217.2
9,273.0
9,775.8
5,928.3
1,187.5
240.6
1,748.8
1,369.1
13,219.7
21,584.8
2,394.9
1,995.6
5,635.2
8,355.3
77.8
176.9
105.0
58,091.4
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
12.0
10.9
29.9
189.7
135.0
80.8
110.0
82.4
2.6
2.0
5.6
35.6
24.4
17.8
27.7
21.9
23.3
14.4
30.0
249.0
180.9
144.0
199.7
158.2
15.6
12.5
27.7
206.5
150.1
109.8
142.1
106.1
170.7
112.0
261.9
1,860.3
1,456.0
1,192.9
1,370.4
910.5
308.9
228.6
425.9
3,515.8
2,330.3
1,769.7
2,100.3
1,523.6
31.2
24.0
58.1
364.2
243.0
160.9
250.4
225.1
26.7
25.0
60.1
318.4
184.6
130.0
192.2
172.6
89.0
67.4
161.2
1,043.4
581.4
371.6
451.2
336.6
86.9
74.2
182.1
1,397.9
875.4
585.6
856.7
721.7
0.9
1.3
3.3
18.2
8.6
3.3
3.7
3.0
4.5
3.8
7.8
48.6
15.9
7.9
6.6
4.6
3.4
3.7
7.6
28.6
7.9
2.9
1.1
0.3
775.8
579.8
1,261.3
9,276.2
6,193.5
4,577.3
5,712.2
4,266.7
Total
650.6
137.6
999.6
770.5
7,334.7
12,203.2
1,356.8
1,109.7
3,101.8
4,780.5
42.4
99.7
55.4
32,642.7
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
14.4
12.3
32.0
126.6
137.2
90.7
84.7
39.0
3.1
2.6
6.0
21.7
23.4
18.5
18.9
8.7
26.1
15.3
33.9
155.2
178.4
148.3
136.5
55.7
19.5
15.2
30.7
127.5
148.9
109.1
104.0
43.6
198.4
128.3
289.0
1,294.1
1,484.9
1,207.9
941.9
340.5
363.7
237.8
476.2
2,171.6
2,225.1
1,811.2
1,524.1
571.9
38.9
27.6
62.0
258.1
236.0
163.7
166.9
84.8
28.1
28.6
65.4
223.4
180.0
135.3
145.5
79.6
105.3
76.6
178.6
717.8
565.3
393.7
344.2
152.0
101.9
86.2
198.3
904.5
811.2
601.7
588.2
282.8
1.2
1.5
3.5
12.0
9.1
4.7
2.6
0.8
6.2
4.3
8.0
28.5
15.9
7.6
4.7
2.0
4.8
4.5
8.0
18.8
8.4
3.3
1.6
0.2
911.7
640.7
1,391.8
6,059.7
6,023.8
4,695.8
4,063.6
1,661.6
Total
536.9
103.0
749.2
598.6
5,885.0
9,381.6
1,038.1
885.9
2,533.5
3,574.8
35.4
77.2
49.6
25,448.7
($' per capita)
Both Sexes
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
5,324.44 3,709.90 5,187.41 4,571.48 4,990.16 5,153.00 4,868.14 4,332.77 5,069.20 4,473.80 5,657.56 16,864.86
1,039.63
700.33
707.71
833.49
710.53
804.28
842.68
983.12
908.20
860.22 1,617.26 2,902.04
888.15
587.60
518.05
600.15
595.61
576.73
721.78
798.98
782.49
738.78 1,439.97 2,034.62
1,259.87
951.50
961.90
977.03
954.08 1,087.37 1,242.28 1,215.64 1,236.40 1,259.59 1,968.67 3,650.93
2,080.83 1,522.40 1,620.09 1,681.85 1,649.97 1,765.64 1,960.82 1,763.32 1,881.47 1,799.49 2,426.45 4,521.00
4,885.33 3,811.88 4,429.36 4,191.32 4,442.99 4,358.63 4,075.98 3,539.71 4,546.49 4,181.08 7,431.42 14,749.20
9,267.29 7,401.42 7,677.05 7,221.35 7,788.08 7,591.15 7,477.00 6,313.35 8,281.55 8,032.42 15,024.56 25,753.98
20,127.29 13,103.47 14,735.45 13,407.69 14,185.16 14,572.40 15,645.29 12,406.01 16,138.83 18,044.13 34,673.66 44,057.20
2,195.49
1,746.61
1,858.13
1,812.20
1,798.31
1,872.40
2,096.14
1,945.87
1,904.02
2,074.17
2,504.94
4,317.27
13,390.18 5,001.36
2,913.55
819.00
2,327.86
648.45
3,704.98 1,106.63
4,935.73 1,760.51
12,860.99 4,344.77
18,696.56 7,723.29
18,694.34 15,107.44
3,910.92
1,904.05
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
4,930.14 3,573.59 5,001.84 4,189.97 4,721.63 4,842.85 4,461.97 4,313.02 4,762.75 4,249.23 4,975.92 14,949.85
990.59
635.67
701.51
781.66
676.39
808.15
800.66
932.55
875.79
819.00 1,607.51 2,786.35
879.91
576.31
500.18
584.10
579.21
559.79
717.22
784.31
763.22
727.48 1,435.45 2,011.62
1,509.35 1,178.93 1,184.60 1,223.55 1,147.15 1,352.32 1,483.58 1,451.98 1,502.19 1,541.94 2,388.28 4,740.66
2,070.96 1,540.46 1,621.43 1,685.19 1,612.20 1,780.03 1,980.05 1,794.43 1,937.75 1,867.31 2,581.11 5,006.04
4,427.32 3,544.52 4,058.21 3,902.08 4,034.17 4,038.32 3,787.52 3,301.08 4,275.48 3,986.56 7,165.77 15,545.82
9,058.58 7,197.52 7,470.84 6,947.78 7,389.67 7,320.17 7,439.81 6,163.22 7,961.42 8,098.84 15,557.33 30,927.67
20,122.06 13,657.75 15,346.71 13,597.77 14,195.35 15,121.40 16,550.76 12,840.29 16,349.61 19,335.69 44,643.07 55,139.13
2,385.73
1,963.07
2,084.48
2,019.76
1,969.59
2,088.73
2,356.09
2,151.03
2,116.38
2,358.72
2,824.35
5,045.13
11,855.38 4,713.59
2,835.86
797.59
2,317.59
632.88
4,670.40 1,354.92
5,256.24 1,771.41
13,508.20 4,023.30
19,172.43 7,482.93
31,408.22 15,581.77
4,343.50
2,119.39
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
5,705.33 3,835.79 5,365.27 4,930.08 5,246.88 5,449.46 5,250.65 4,351.71 5,360.53 4,685.02 6,335.63 18,596.94
1,087.16
759.19
713.64
881.58
743.27
800.59
882.98 1,032.20
938.77
899.18 1,625.71 3,013.13
895.98
598.45
534.98
615.44
611.28
592.78
726.09
812.97
800.74
749.47 1,444.24 2,057.44
1,009.76
722.89
738.95
736.71
768.22
825.52 1,010.40
986.69
983.45
981.78 1,553.73 2,623.02
2,090.64 1,504.06 1,618.72 1,678.50 1,688.76 1,750.81 1,941.40 1,732.51 1,826.90 1,731.62 2,295.19 4,121.19
5,380.74 4,110.48 4,861.18 4,529.30 4,937.09 4,724.80 4,405.67 3,803.92 4,835.85 4,389.55 7,628.62 13,999.71
9,553.42 7,722.22 8,000.22 7,631.89 8,451.02 7,999.22 7,533.52 6,523.31 8,742.34 7,937.59 14,328.76 20,856.23
20,138.32 11,893.59 13,237.29 12,966.40 14,157.98 13,287.12 13,662.13 11,558.63 15,690.69 15,416.08 18,532.73 29,952.92
2,002.02
1,522.39
1,623.01
1,600.50
1,622.45
1,650.10
1,831.95
1,738.19
1,695.70
1,786.03
2,205.89
3,638.84
14,729.05 5,275.44
2,981.42
839.39
2,337.62
663.23
2,817.19
864.21
4,669.50 1,749.44
12,337.88 4,711.75
18,388.64 8,088.50
12,337.39 14,012.13
3,519.33
1,684.52
CIHI 2002
Note: See methodology for age-sex distribution in the Methodological Notes section of this report.
174
NATIONAL HEALTH EXPENDITURE TRENDS D A T A T A B L E S
Table E.1.3
Estimate of Total Provincial/Territorial Government Health Expenditures by Age and Sex,
by Province/Territory and Canada, 2000 - Current Dollars
Nfld.
P.E.I.
N.S.
N.B.
Que.
Ont.
Man.
Age
Groups
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
Sask.
Alta.
B.C.
Y.T.
N.W.T.
Nun.
Canada
($' 000,000)
Both Sexes
27.4
22.7
62.1
324.8
293.5
187.5
203.8
127.2
5.7
5.0
12.4
60.7
52.9
39.4
49.0
33.5
45.8
27.4
64.2
401.9
387.9
288.0
338.8
233.1
36.3
27.1
59.8
351.8
329.5
233.9
267.9
163.2
372.4
232.3
558.8
3,223.2
3,184.3
2,590.5
2,572.7
1,397.1
735.0
490.0
1,021.4
6,250.1
5,165.0
3,963.8
4,125.1
2,358.3
78.3
64.9
131.8
684.0
539.1
344.7
447.2
338.7
56.3
51.7
121.5
547.7
388.2
278.2
365.9
283.5
216.8
155.4
366.3
1,912.8
1,304.3
842.7
872.6
538.0
195.3
169.2
417.9
2,447.5
1,872.4
1,271.5
1,581.6
1,164.4
2.2
2.7
7.0
31.0
19.4
8.3
7.4
4.3
9.1
6.3
13.1
67.2
29.5
14.5
10.5
8.0
13.7
8.9
16.9
57.8
20.8
8.3
3.4
1.1
1,794.3
1,263.5
2,853.1
16,360.7
13,586.9
10,071.3
10,845.9
6,650.1
1,249.1
258.5
1,787.2
1,469.4
14,131.2
24,108.7
2,628.7
2,092.9
6,208.9
9,119.8
82.3
158.2
131.0
63,425.8
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
12.8
10.5
29.7
193.9
142.3
86.0
113.7
83.8
2.5
2.1
5.9
37.2
26.7
19.5
29.0
23.6
21.8
13.2
30.6
248.7
192.6
142.4
207.9
171.5
16.5
12.2
28.7
216.0
164.6
118.5
156.5
115.1
172.3
108.0
267.8
1,887.3
1,576.2
1,284.8
1,521.8
1,016.6
332.8
232.5
483.2
3,853.2
2,643.0
1,953.0
2,392.5
1,702.0
35.7
35.2
63.7
397.7
274.3
171.5
268.9
246.7
25.9
24.2
57.7
320.2
197.0
135.6
207.3
195.9
101.9
72.3
174.1
1,131.1
663.2
407.6
492.0
370.3
90.5
77.4
195.8
1,433.6
923.1
602.2
918.9
832.2
1.0
1.3
3.3
18.6
9.3
3.6
4.4
3.3
4.0
3.0
6.5
42.5
14.4
7.7
6.1
5.5
5.8
4.0
8.1
36.4
10.1
4.0
1.3
0.4
823.5
596.1
1,355.1
9,816.3
6,836.8
4,936.4
6,320.4
4,767.0
Total
672.6
146.7
1,028.6
828.2
7,834.9
13,592.2
1,493.9
1,163.8
3,412.4
5,073.6
44.9
89.8
70.2
35,451.6
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
14.6
12.1
32.4
131.0
151.2
101.6
90.2
43.5
3.1
2.8
6.5
23.4
26.3
19.8
19.9
9.9
24.1
14.2
33.6
153.3
195.4
145.6
130.9
61.6
19.8
14.8
31.1
135.8
164.9
115.3
111.3
48.1
200.1
124.3
291.0
1,335.9
1,608.0
1,305.7
1,050.8
380.5
402.2
257.4
538.3
2,396.9
2,522.0
2,010.8
1,732.6
656.2
42.6
29.6
68.1
286.2
264.9
173.2
178.3
92.0
30.5
27.5
63.8
227.5
191.2
142.6
158.6
87.5
114.9
83.1
192.2
781.8
641.1
435.1
380.6
167.7
104.8
91.8
222.0
1,013.9
949.4
669.3
662.7
332.2
1.3
1.4
3.6
12.3
10.0
4.7
3.1
0.9
5.1
3.3
6.6
24.7
15.1
6.8
4.4
2.4
7.9
4.9
8.8
21.5
10.7
4.3
2.1
0.6
970.8
667.4
1,498.0
6,544.3
6,750.1
5,134.8
4,525.5
1,883.2
Total
576.4
111.8
758.6
641.2
6,296.3
10,516.5
1,134.9
929.2
2,796.5
4,046.1
37.4
68.4
60.8
27,974.2
($' per capita)
Both Sexes
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
5,319.24 3,753.78 4,817.81 4,737.48 5,057.79 5,610.31 5,458.67 4,518.70 5,704.76 4,739.56 6,372.33 14,452.62
1,054.23
775.69
675.07
837.34
716.13
868.90 1,091.08
980.32
985.71
938.63 1,709.81 2,416.87
926.27
639.05
528.32
625.04
604.64
645.73
791.05
784.40
843.75
814.43 1,529.29 1,675.72
1,318.47 1,007.98
964.76 1,041.56
983.02 1,182.95 1,370.85 1,243.15 1,330.61 1,341.73 2,079.95 3,226.56
2,175.33 1,631.85 1,699.23 1,792.33 1,733.19 1,936.12 2,143.20 1,824.42 2,039.84 1,926.51 2,570.08 4,068.42
5,276.05 4,090.08 4,343.30 4,489.91 4,773.70 4,806.82 4,382.23 3,766.04 4,906.95 4,455.64 7,378.39 13,170.43
9,674.57 7,764.15 7,661.03 7,727.00 8,352.84 8,344.91 7,954.89 6,844.27 8,797.26 8,581.11 16,740.31 23,402.52
20,157.41 13,776.24 15,318.62 14,069.05 15,051.95 15,650.11 16,408.51 13,387.36 16,709.92 19,459.49 38,519.23 49,254.55
2,322.25
1,868.35
1,896.64
1,944.60
1,914.34
2,061.00
2,292.94
2,047.95
2,062.85
2,246.18
2,689.45
3,871.65
19,016.70 5,337.29
3,369.20
873.72
2,434.95
696.28
4,435.30 1,179.29
5,999.81 1,892.76
15,895.88 4,699.12
25,079.76 8,325.05
42,131.22 16,094.07
4,762.17
2,059.89
Female
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
5,125.47 3,347.75 4,620.86 4,472.59 4,833.03 5,211.29 5,066.82 4,198.41 5,450.14 4,537.38 5,738.18 12,733.87
991.42
696.86
661.31
786.87
680.18
843.67 1,214.40
932.53
943.23
882.54 1,696.29 2,363.39
908.55
621.71
518.16
613.18
592.19
628.14
786.42
762.21
825.32
784.97 1,516.15 1,644.38
1,572.66 1,234.80 1,191.93 1,296.85 1,174.51 1,469.04 1,626.20 1,476.01 1,611.66 1,584.21 2,516.30 4,209.01
2,116.51 1,631.54 1,672.24 1,788.21 1,694.74 1,951.50 2,167.69 1,861.55 2,108.95 1,895.28 2,669.75 4,422.82
4,646.53 3,845.52 4,022.00 4,228.34 4,342.64 4,456.17 4,104.22 3,499.34 4,610.38 4,099.90 7,142.69 14,318.87
9,346.65 7,536.26 7,715.58 7,509.64 7,940.71 8,066.83 7,958.02 6,645.68 8,435.19 8,501.50 18,074.34 28,398.68
19,716.75 14,134.05 15,842.71 14,194.96 15,062.85 16,213.58 17,364.28 13,942.90 16,947.09 20,751.01 49,793.79 58,987.54
2,479.99
2,082.13
2,139.76
2,170.27
2,095.66
2,293.75
2,584.49
2,261.63
2,288.47
2,482.07
3,025.96
4,548.68
16,931.54 5,025.83
3,290.60
844.14
2,400.61
678.85
5,757.45 1,432.95
6,383.70 1,889.97
16,574.56 4,336.84
28,416.34 8,062.37
64,006.68 16,569.52
5,344.91
2,280.75
Male
<1
1–4
5–14
15–44
45–64
65–74
75–84
85+
Total
5,502.25 4,159.26 5,010.69 4,983.95 5,268.80 5,989.88 5,837.89 4,831.98 5,951.22 4,929.24 6,957.43 16,144.18
1,115.71
848.00
688.32
884.04
750.59
893.02
973.59 1,026.71 1,025.90
991.74 1,721.86 2,468.70
943.13
655.71
537.95
636.36
616.57
662.38
795.43
805.59
861.18
842.31 1,541.60 1,707.40
1,063.91
780.46
736.94
793.12
798.99
900.90 1,125.32 1,017.29 1,062.53 1,103.02 1,648.61 2,301.68
2,233.77 1,632.17 1,726.69 1,796.46 1,772.61 1,920.27 2,118.41 1,787.67 1,972.96 1,957.88 2,483.75 3,778.96
5,959.45 4,363.37 4,711.60 4,794.75 5,290.43 5,204.58 4,697.28 4,060.33 5,221.60 4,832.95 7,571.20 12,072.99
10,122.36 8,121.96 7,575.96 8,054.71 9,031.68 8,761.98 7,950.19 7,122.41 9,314.11 8,693.99 15,135.50 18,772.45
21,064.35 12,988.50 14,026.72 13,776.81 15,022.90 14,356.10 14,297.41 12,291.33 16,209.05 16,835.02 21,351.14 35,800.12
2,161.80
1,646.61
1,643.45
1,714.37
1,728.28
1,822.05
1,996.49
1,831.25
1,841.33
2,006.99
2,372.72
3,238.89
20,914.29 5,633.43
3,437.20
901.95
2,467.24
712.84
3,193.36
931.85
5,679.23 1,895.59
15,318.28 5,109.45
23,317.75 8,721.93
33,624.09 15,004.24
4,230.22
1,834.74
CIHI 2002
Note: See methodology for age-sex distribution in the Methodological Notes section of this report.
175
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