Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 143<br />
There have been few studies of the technical efficiency of health systems in<br />
<strong>Canada</strong>, in part because of the challenge posed by the large number of inputs as<br />
well as outputs in a complex health system whether it is a RHA or a provincial<br />
health system. However, there is increasing interest among OECD countries,<br />
including <strong>Canada</strong>, in conducting some “value <strong>for</strong> money” assessments (OECD,<br />
2010a,b).<br />
At least to some extent, the recent application of “lean production”<br />
methodologies in some provincial health systems and RHAs is an ef<strong>for</strong>t to<br />
achieve greater technical efficiency. First developed by the Japanese care<br />
manufacturer Toyota to achieve greater technical efficiency and higher quality<br />
in automobile production, lean techniques were first adapted to three hospitals<br />
in Ontario in 2005, followed by a RHA and a Catholic hospital in Saskatchewan<br />
one year later. The objective of these lean projects ranged from reducing surgical<br />
waiting times to improving patient safety (Fine et al., 2009). There has not yet<br />
been a systematic evaluation of these and subsequent lean initiatives in <strong>Canada</strong>,<br />
but one comparative study of its impact on 15 hospital emergency departments<br />
in three countries – Australia, <strong>Canada</strong> and the United States – found that there<br />
was a decrease in waiting times, total length of stay and the proportion of<br />
patients leaving emergency departments without being diagnosed or treated,<br />
as well as improvements in patient satisfaction (Holden, 2011).<br />
7.6 Transparency and accountability<br />
<strong>Health</strong> systems in <strong>Canada</strong> are more transparent today than in decades past due<br />
to a number of trends and movements. Canadians, whether in their various<br />
roles as citizen, taxpayer or patient, demand greater transparency of their<br />
governments and health care organizations than in the past. On the supply side,<br />
they now have access to in<strong>for</strong>mation from a number of new provincial and<br />
intergovernmental organizations including the <strong>Health</strong> Council <strong>Canada</strong>, which<br />
provides accessible reports on the state of Canadian health care. In addition, a<br />
number of think tanks also provide reports on health system issues that are of<br />
concern and interest to Canadians.<br />
<strong>Health</strong> <strong>Canada</strong> provides a yearly report to governments and the general<br />
public on the <strong>Canada</strong> <strong>Health</strong> Act, including any in<strong>for</strong>mation concerning<br />
provincial governments that may be in breach of the Act and its five basic<br />
criteria of public administration, comprehensiveness, universality, portability<br />
and accessibility (<strong>Health</strong> <strong>Canada</strong>, 2011). However, concerns have been raised<br />
about what is actually included in the basket of universal health services under