[Out-of-pocket health care costs among population groups in Iceland.]

Total health expenditures, and out-of-pocket health care costs have increased in recent years in Western Europe and North America. Developments in Iceland appear to be similar. Access and cost are closely related and direct household health care costs often reduce subsequent use of services. The purpose of the study was to consider whether certain population groups spent more on health care than others both in absolute terms and as percentage of household income.

The study is based on a national health survey titled Health and Living Conditions in Iceland. A random sample of 18-75 year olds was drawn from the National Register, and the response rate was 69% (1924 respondents). Average household out-of-pocket health care costs (in krónur) and out-of-pocket household costs as percentage of household income were compared between sociodemographic groups.

The largest health care expenditure items were dental care, drugs, other drug store items and equipment, and physician care (in this order). The middle aged (45-54), married/cohabiting, parents, large households, full-time employed, and people with high education and income, had the greatest household out-of-pocket costs in absolute terms. However, when considering costs as percentage of household income, women, older individuals (age 55 and older) and the young (age 18-24), the non-employed and unemployed, and low income people were on top.

Household out-of-pocket health care costs differ substantially between sociodemographic groups in Iceland. It can be argued and empirically substantiated that out-of-pocket health care costs in Iceland are already at a risky level, affecting access of individuals and groups to health services.