加拿大的医疗保健费用是否可承受？2004年至2014年加拿大医疗保健系统的比较分析。
Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014.
作者信息
Soril Lesley J J, Adams Ted, Phipps-Taylor Madeleine, Winblad Ulrika, Clement Fiona
机构信息
PhD Candidate, Department Community Health Sciences, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB.
Staff Physician, Liverpool Women's Hospital NHS FT, Department of Obstetrics and Gynaecology, Liverpool, UK.
出版信息
Healthc Policy. 2017 Aug;13(1):43-58. doi: 10.12927/hcpol.2017.25192.
OBJECTIVE
To compare cost-related non-adherence (CRNA), serious problems paying medical bills and average annual out-of-pocket cost over time in five countries.
METHODS
Repeated cross-sectional analysis of the Commonwealth Fund International Health Policy survey from 2004 to 2014. Responses were compared between Canada, the UK, Australia, New Zealand and the US.
RESULTS
Compared to the UK, respondents in Canada, Australia and New Zealand were two to three times and respondents in the US were eight times more likely to experience CRNA; these odds remained stable over time. From 2004 to 2014, Canadian respondents paid US $852-1,767 out-of-pocket for care. The US reported the largest risks of serious problems paying for care (13-18.5%), highest out-of-pocket costs (US $2,060-3,319) and greatest rise in expenditures.
INTERPRETATION
Over the 10-year period, financial barriers to care were identified in Canada and internationally. Such persistent challenges are of great concern to countries striving for equitable access to healthcare.
目的
比较五个国家中与费用相关的治疗不依从情况（CRNA）、支付医疗账单的严重问题以及随时间推移的平均年度自付费用。
方法
对2004年至2014年英联邦基金国际卫生政策调查进行重复横断面分析。比较了加拿大、英国、澳大利亚、新西兰和美国的调查结果。
结果
与英国相比，加拿大、澳大利亚和新西兰的受访者出现CRNA的可能性是英国受访者的两到三倍，而美国受访者出现CRNA的可能性是英国受访者的八倍；随着时间的推移，这些几率保持稳定。2004年至2014年期间，加拿大受访者为医疗护理自付了852至1767美元。美国报告称，支付医疗费用出现严重问题的风险最大（13%-18.5%），自付费用最高（2060至3319美元），支出增长幅度最大。
解读
在这10年期间，加拿大和国际上都发现了医疗护理的经济障碍。对于努力实现公平医疗服务的国家而言，此类持续存在的挑战令人高度担忧。
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