Economic Burden of Illness in Canada, 1993

APPENDIX 7

Comparison of Age and Sex Distributions with Other Data Sources

The National Health Expenditures in Canada, 1975-1994 (NHEC) ¹ provides the age and sex breakdown for provincial governments' expenditures for many of the direct cost components. Since the proportion of the total national expenditure that the provincial expenditures represent varies by cost component, some cost components (e.g. physicians, 97.4%; hospitals, 86.9%) are more reliable to use in making comparisons than others (e.g. drugs, 30.7%; other professionals, 12.3%). Preliminary 1992/93 data from the National Physician Database (NPDB)² also provide a distribution of fee-for-services physician claims by age and sex for all provinces except Quebec.

The table in this appendix compares the age and sex distributions of several cost components provided by the two data sources above as well as by our own report (Burden '93).

Physician Care Expenditures

We estimated that female patients were responsible for 59.8% of the cost of physician care in 1993. This proportion is very similar to that calculated from the NPDB² in 1992/93 (59.6%) and the proportion shown in the NHEC ¹ (58.9%) for 1993. However, our age distribution of expenditures varies somewhat from the NHEC and NPDB distributions.

The use of an age distribution for only one province (Manitoba) to calculate our costs may explain part of this discrepancy. Physician expenditures for Manitoba differ slightly from the national average. However, Manitoba provides age and sex breakdowns for each diagnostic category; the NHEC and NPDB are unable to provide this detail.

Hospital Care Expenditures

Our proportion of hospital expenditures attributed to females (53.6%) is lower than that shown in the 1993 NHEC ¹ data (57.5%). Comparison of our percentage distribution of hospital care expenditures by age group with that of the NHEC shows considerable differences. The NHEC age distributions are based on hospital expenditures of the provincial governments that represent 86.9% of the national hospital expenditure and include hospital drugs. We excluded the cost of hospital drugs from our hospital expenditure, including it in Drug Expenditures instead.

Drug Expenditures

Females accounted for 55.6% of the prescription drug costs for 1993 that we were able to categorize by sex. Although this figure is consistent with the 56.8% estimated by the NHEC,¹ the age distribution between the two sources differs. This is because the NHEC provincial governments' drug expenditures represent only 30.7% of the total drug expenditure and exclude drugs dispensed in hospitals. In this report, we were able to categorize more than 90% of all prescription drugs sold in pharmacies by age and sex. We also estimated hospital drug expenditure by age and sex.

Expenditures for Care in Other Institutions

We were unable to categorize expenditures for other institutions. The NHEC¹ classified 69.8% ($4.9 billion) of the expenditures by age and sex. Females represented 62.3% ($3.0 billion) of these costs. The 65+ age group made up 72.5% ($3.5 billion) of the expenditure for other institutions. These NHEC estimates are consistent with the large proportion of this expenditure represented by homes for the aged (82%).

Other Professionals and Other Health Expenditures

We were unable to categorize other professionals and other additional direct health expenditures. Similarly, the NHEC ¹ could provide estimates by age and sex for only 12.3% of expenditures for care by other professionals (including dentists and denturists), and for only 51.3% of other expenditures.

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