Lively debate has raged over our cover story last week on health care. Sorting out where Canadian care stands in international comparisons is no simple matter. For anyone with an appetite for data on this subject, I suggest the OECD’s Health at a Glance 2009 document.
The way the OECD separates statistics into categories helps keep different parts of the argument straight. For instance, figures that have to do with society, like those for traffic fatalities and suicides, are gathered under a separate heading from stats that have to do with the health system itself. So are numbers like how many people are overweight or smoke.
The OECD groups together data about access to care and the health workforce, and also statistics on spending on care. All worth close attention. But for the purposes of determining how well Canadian hospitals, clinics and doctors’ offices perform, some of the most immediately useful numbers are those you’ll find in the “Quality of Care” section. How well does the system do when it comes to keeping people out of hospital, and caring for those who end up there?
These numbers aren’t about the underlying healthiness of the population, or with stresses and strains in the funding of the system. They’re about what actually happens to those who clearly need care. As the OECD puts it, these numbers are meant to provide some help in answering the question, “Which areas of the health care system are providing value-for-money and which show opportunities for performance improvement?”
Here’s a quick look at how Canada ranks on 14 “Quality of Care” numbers the OECD highlights. In most cases, the OECD has data for about twenty countries. Canada ranks below the average of the club of developed economies on two of these fourteen indicators:
1. Dying in hospital after a heart attack: Canada ranks fifth best
2. Admission to hospital for asthma: Canada ranks second best
3. Admission for diabetes: Canada ranks fifteenth (below average)
4. Admission for congestive heart failure: Canada ranks fourth best
5. Admission for high blood pressure: Canada ranks third best
6. Dying in hospital after a stroke: Canada ranks nineteenth (below average)
7. Unplanned readmission for schizophrenia: Canada ranks fifth best
8. Unplanned readmission for bipolar disorder: Canada ranks sixth best
9. Screening for breast cancer: Canada ranks seventh best
10. Survival rate for breast cancer: Canada ranks third best
11. Cervical cancer screening: Canada ranks fifth best
12. Survival rate for cervical cancer: Canada ranks second best
13. Survival rate for colorectal cancer: Canada ranks fourth best
14. Flu vaccination rates for seniors: Canada ranks fifth best
(The only stats from the section that I’ve intentionally left out are those on childhood vaccination rates; these seem to me to be a mainly a function of public policy on when kids should get their shots, and so they don’t tell us much about the health system per se.)