assembling canada’s health system profile for the european observatory monitoring health systems...
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Assembling Canada’s Health System Profile for the European Observatory
Monitoring Health Systems Change/ReformsPAHO/WHO Seminar, Belize, 30 May 2006
Gregory P. Marchildon, Ph.D.Canada Research Chair in Public Policy and Economic History
Graduate School of Public Policy, University of Regina
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G.P. MarchildonGraduate School of Public Policy
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G.P. MarchildonGraduate School of Public Policy
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Comparative Template
• European Observatory on Health Systems and Policies (WHO Regional Office for Europe)
• Health Care Systems in Transition (HiT) profiles: focus on Europe but a few exceptions …
• Australia, New Zealand, and now …• Canada• Common questions• Compulsory tables, figures, and diagrams
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G.P. MarchildonGraduate School of Public Policy
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Comparator Countries
• Canada not part of WHO’s European database• Rely on OECD health database (2004)• 5 countries selected on basis of history, size,
wealth and political or policy considerations– Australia– France– Sweden– United Kingdom – United States
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G.P. MarchildonGraduate School of Public Policy
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Systematic Comparisons: Quantitative and Qualitative
1. Health status2. Organizational structure: governance and
management3. Financial resources: revenues and
expenditures4. Regulation and planning5. Physical and human resources6. Provision of services7. Health care reforms8. Assessment: public, mixed and private
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Total Health care expenditures as a share of GDP in Canada and selected countries, 1960 to 2002
0
2
4
6
8
10
12
14
161
96
0
19
70
19
80
19
85
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
% o
f G
DP
AUST CAN FR SWE UK US
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Public Health Care Expenditures as a share of GDP in Canada and selected countries, 1960 to 2002
0
1
2
3
4
5
6
7
8
91
96
0
19
70
19
80
19
85
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
% o
f G
DP
AUST CAN FR SWE UK US
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Comparatives Trends in real PUHE, PRHE, and THE, cumulative % change, 1990-2001
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Comparative Health Status Indicator Rankings (OECD rankings in brackets)
Life Expectancy at
Birth(1999)
Potential Years of LL per 100,000
(1997)
Perinatal Mortality per
100,000 (1999)
DPT Immunization% of Children
(1997)
Measles Immunization% of Children
(1998)
SWEDEN 1 (4) 1 (1) 2 (7) 1 (2) 1 (6)
CANADA 2 (5) 2 (8) 3 (13) 4 (22) 2 (7)
AUSTRALIA 3 (7) 3 (9) 1 (3) 6 (25) 5 (18)
FRANCE 4 (8) 5 (15) 4 (17) 2 (8) 6 (19)
UK 5 (18) 4 (10) 5 (18) 3 (18) 4 (15)
USA 6 (20) 6 (22) 6 (20) 5 (23) 3 (13)
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Malignant Neoplasms
(2000)
Cerebro-vascular Diseases
(2000)
Respiratory
System Diseases
(2000)
Ischaemic Heart
Diseases (2000)
SWEDEN 1 (2) 5 (11) 1 (4) 4 (16)
CANADA 4 (15) 1 (2) 3 (10) 3 (12)
AUSTRALIA 2 (8) 4 (5) 4 (12) 2 (11)
FRANCE 5 (18) 2 (3) 2 (8) 1 (3)
UK 6 (20) 6 (18) 6 (25) 6 (22)
USA 3 (14) 3 (4) 5 (22) 5 (21)
Comparative Disease Indicator Rankings (OECD rankings in brackets), 2000
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Observations and Conclusions
• Importance of comparative perspective• Allows you to ask better questions• But rarely provides direct or conclusive
answers• Health system performance?
– Health status– Health care (amenable mortality)– Fiscal performance– Patient/user/citizen satisfaction