Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
policy objectives, including shifting more resources from curative care to
illness prevention and health promotion interventions and initiatives at both
the individual and population health level.
Influenced by the quality improvement movements and initiatives in
the United States and the United Kingdom, ministries of health in Canada
also established institutions and mechanisms to improve the quality, safety,
timeliness and client-responsiveness of health services. Six provincial
governments set up quality councils to work with health organizations and
providers to provide higher-quality care, reduce the rate of medical errors and
improve both efficiency and health care outcomes. Most ministries and RHAs
use at least some indicators and measures to identify poor performance and
improve both processes and outcomes. At the pan-Canadian level, the Health
Council of Canada identifies best practices and evaluates performance in key
health reform areas and disseminates the results to all governments as well as
the general public.
By the mid- to late 1990s, governments were beginning to invest time
and resources in their health information, research and data management
infrastructures. In 1994, the federal and provincial governments established
the CIHI to hold, improve, use and disseminate administrative data as part of a
larger effort by governments to better understand and evaluate their respective
health systems. CIHI was initially a consolidation of activities from Statistics
Canada, health information programmes from Health Canada, the Hospital
Medical Records Institute and the Management Information Systems group.
In partnership with Statistics Canada, CIHI has grown into one of the world’s
premier national health information repositories, with extensive databases on
health spending, services, infrastructure and human resources.
These improvements in the collection, organization and dissemination
of health system data were spurred by the recommendations of arm’s length
commissions and ministerial task forces, including major reports for provincial
governments in Ontario (2000), Quebec (2000), Saskatchewan (2001) and
Alberta (2001) as well as for the federal government (Romanow 2002; Senate
of Canada, 2002). At the same time, health ministries in Canada have been
less willing than other OECD health ministries to use performance indicators
as a tool in managing the delivery organizations in their respective health
systems. They have been reluctant to create the intergovernmental processes
and institutions to facilitate systematic comparisons of the performance