Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
This argument also applies to population health interventions – the so-called
non-medical or social determinants of health. Despite the achievements made
by Canadians in the early conceptualization on the importance of population
health factors, it appears that the country’s track record on the ground has been
poor. Bryant et al. (2011) argued that ground has been ceded in the following
five areas since the 1980s: (1) redistributive impact of tax and transfer policies;
(2) family and child poverty; (3) housing policy; (4) early childhood education
and care; and (5) urban and metropolitan health planning and policy.
7.4.2 Health service outcomes and quality of care
For years, the CIHI has been collecting and refining data in order to produce
health service quality measures. Building an index of quality based on eight
CIHI measures, Marchildon & Lockhart (2010) found that that there has been
an overall trend towards quality improvement in Canada since the late 1990s
(Fig. 7.1). While the OECD has recently launched a major quality indicators
project, it is not yet possible to compare Canada with other OECD countries in
terms of direct health service quality measures.
Fig. 7.1
Index and trend of eight quality indicators, 1999–2009
Index values
1999
2000
2001
2002
2003
2004
Canada composite index
Trend line
Source: Marchildon & Lockhart (2010).
Note: Although the eight CIHI indicators are focused on acute care, ambulatory sensitive conditions and hospital readmissions for
particular conditions are used to determine the continuity of care beyond acute care and are therefore used as a broader measure of
health system quality.
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