A new cross-country study presents fresh evidence that Canada may not be getting the best value for the money it spends on public healthcare.
In a comparison of 28 universal healthcare systems in high-income countries, authors Bacchus Barua and David Jacques of the Fraser Institute found that Canada is among the highest spenders among universal healthcare systems.
Countries were compared based on their age-adjusted healthcare spending — the percentage of their GDP spent on public healthcare, adjusted for the age of their population — and their per-capita healthcare spending in 2016. Based on its age-adjusted healthcare spending (11%), Canada ranked fourth out of all the countries studied; looking at its healthcare expenditure per capital (US$4,919.6, in purchasing-power-parity dollars), the country ranked tenth.
“Data suggests that Canada has substantially fewer human and capital medical resources than many peer jurisdictions that spend comparable amounts,” Barua and Jacques said. The country had 2.7 physicians for every 1,000 patients, putting it in 26th place. And for every thousand patients, it also had just 2.1 acute-care beds (25th place) and 0.4 psychiatric beds (25th place). Looking at the availability of MRI units, the study found Canada had 9.9 for every one million patients, making it 22nd out of 27 countries.
Canada also performed very poorly when it came to timeliness of care, placing last in four out of five measures. That included percentage of sick patients who were able to get an appointment by the next day (43%), had to wait at least four weeks to get an appointment with a specialist (56.3%), waited at least two months for a specialist appointment (30%), and waited a minimum of four months for elective surgery (18%).
In terms of the use of healthcare resources, the authors found mixed performance. Canada did better than the average OECD country in about half of the indicators examined, including doctor consultations and knee-replacement surgeries. However, it got middling-to-low scores on the rest of the measures like MRI exams and appendectomies. Hospital activity in Canada, as measured by discharge rates, was also lowest among all countries studied.
When it came to quality and clinical performance, Canada ranked well on five indicators such as hip-fracture surgeries initiated within 48 hours of admission to hospital (fourth out of 22) and care and patient safety for breast cancer cases (sixth out of 26). But it was average or below-average for the remaining seven indicators, particularly obstetric traumas and diabetes-related amputations.
“The data examined in this report suggest that there is an imbalance between the value Canadians receive and the relatively high amount of money they spend on their health-care,” the authors concluded.
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