CALGARY, AB—Residents of Quebec and Ontario receive better value for money from their public health care systems than other Canadians, concludes a new report from the Fraser Institute, Canada's leading public policy think-tank.
Provincial Healthcare Index 2013 compares the per-capita cost of provincial health care systems to the availability and quality of medical goods and services in each province. The report measures 46 performance indicators comprising availability of resources, timeliness, volume of services provided, and clinical performance using publically available data from 2010 (or the most recent year available).
Quebec’s health care system ranked highest overall followed by Ontario and New Brunswick, while Newfoundland and Labrador, Prince Edward Island, and Saskatchewan provide the least value for money. The overall rankings are below.
“Measuring and reporting the performance of health care systems is vital for ensuring accountability and transparency. This study allows policymakers and taxpayers to judge whether they receive good value for their health care dollars,” said Nadeem Esmail, Fraser Institute Director of Health Policy Studies.
The report analyzes five key areas of health system performance:
Availability of resources
Quebec performed best overall in availability of medical resources (including physicians, specialists, nurses, medical technologies, and drugs approved for public reimbursement) per capita. New Brunswick and Newfoundland and Labrador ranked second and third while Manitoba, Saskatchewan, and Prince Edward Island have the fewest medical resources among the provinces.
Volume of medical services
Ontario performs the largest number of medical services per capita, including services provided by family physicians, medical specialists, and surgical specialists as well as diagnostic imaging. New Brunswick and Alberta ranked second and third while Prince Edward Island, British Columbia, and Saskatchewan provide the fewest services among all provinces.
Wait for treatment
Ontario offers the timeliest access to medical services in Canada followed by Quebec and Alberta. The longest delays for specialist appointments, surgery, diagnostic imaging, and pharmaceutical approvals among the provinces are found in Prince Edward Island, Newfoundland and Labrador, and British Columbia.
Alberta was found to have the best overall clinical performance among the provinces in terms of mortality rates, hospital re-admission rates, and patient safety, followed by Manitoba and Quebec. Saskatchewan performed most poorly, followed by British Columbia and Newfoundland and Labrador.
Quebec spends the least on health care per capita followed by British Columbia and Ontario, while Newfoundland and Labrador, Alberta, and Saskatchewan spend the most.
“This study reveals how provinces have struck different balances between health expenditures and health system performance. For example, Quebec is able to offer its residents a relatively high-value health care system at a low cost, while Newfoundland and Labrador does its residents a disservice by providing only average value at a very high cost. Low-cost, low-value BC and high-cost, high-value Alberta fall in the middle of the pack in terms of overall value for money,” Esmail said.
“On a national basis, Canada’s health care system provides very poor value for money in comparison with universal-access health care systems in other developed nations. However, some Canadian provinces clearly provide better value for money in health care than others.”
Overall Value for Money: Health Care
- New Brunswick
- Nova Scotia
- British Columbia
- Prince Edward Island
- Newfoundland and Labrador