Health Canada Report: Measuring and reporting on health system performance in Canada

May 25, 2012 – The Health Council of Canada (HCC) released a report looking at how well various health sectors across the country measure and report on the performance of Canada’s health care system. The report found that we are not doing very well on either front.

Although many organizations, governments, provincial health quality councils, and researchers are developing data on health indicators and health care system performance measures, multiple approaches to data analysis and reporting has produced inconsistent and incomparable results. This scattershot approach to measuring health system progress, compromises the ability to measure and understand the bigger picture of Canada’s health system performance. However, the report identified areas of improvement that may help introduce a unified approach to consistent comparisons over time that may ultimately lead to better health outcomes and system accountability.

Achieving a high performing health system requires more than data collection

Large amounts of health data have been collected since the federal government’s 2003 and 2004 agreements with provinces and territories to improve health care following the  Romanow and Kirby health reports. However, more information does not necessarily equate to improved performance reporting of our health care system, especially when most data lacks adequate interpretation or discussion explaining how the data relates to progress in our health care system. Additionally, the report found that the provinces and territories use different measurements, benchmarks, and methods of data collection, making it difficult to compare health outcomes across Canada. It is difficult to improve the health system if we don’t understand what the information is telling us. Likewise, we cannot know if our health care system is delivering better health outcomes nationally when everyone is using different methods of measuring and reporting.

We need a pan-Canadian approach to health system evaluation

Without a comprehensive and unified approach to  health reporting and measuring that allow consistent comparisons over time and geographical space, it is difficult to know whether our health care system is having the desired impact on health outcomes and health status of Canadians. It also fails to tell us where in the health care system we need more improvement. As a result, the Health Council of Canada’s report recommends creating a pan-Canadian performance reporting system. Beyond reducing redundancy and aligning provincial and territorial reporting methods, a pan-Canadian system may be effective in creating a comprehensive national picture of health system performance, health outcomes, and health status. To achieve this national picture, the HCC recommends identifying specific health goals with targets and benchmarks, each with a series of measures for monitoring and reporting. The report also recommends a commitment to independent monitoring and reporting with potential financial incentives to strengthen accountability.

Regardless of age and health needs, it is in the interest of all health care users that information is aligned and understood across the country so that our health systems can improve. Health planners will better understand where more resources are needed, health providers will better understand how they can better deliver services, and users will be able to make better choices. We are not there yet but we now know which direction to take.

Unfortunately, since the Federal Government has walked away from renegotiating the Health Accords, there is no clear leadership to get us to a higher functioning, more accountable, health system. The HCC’s mandate may be to show us where the gaps are, but Canadians are left wondering who will fill those gaps. In lieu of Federal leadership, CARP is calling on provincial and territorial governments to come together and negotiate national standards for healthcare.

Read the full HCC report