Provincial Healthcare Index 2013
by Bacchus Barua
Key findings This study provides a framework for measuring the provision of healthcare in comparison to healthcare expenditures, across provinces, in Canada. The provision of healthcare in each province is captured using 46 indicators, aggregated into four broad components:  availability of resources;  use of resources;  access to resources and  clinical performance of medical goods and services. When compared to other provinces, Quebec receives the best value for money from its public healthcare system, followed by Ontario and New Brunswick. Conversely, Newfoundland & Labrador receives the least value for money from its public healthcare system, followed by Prince Edward Island and Saskatchewan. The Provincial Healthcare Index 2013 reveals how provinces have struck different balances between health expenditures and health system performance, enabling policymakers and taxpayers to discern whether they receive good value for their health care dollars.
Executive summary Introduction / 7 / / / 9 11 23 / 37 31 / iii
What is measured? Why is it measured? How is it measured?
Results by component Results by province Conclusion References / / 59 61 /
About the author / Acknowledgments /
69 69 / 70 / 71 / 72
Supporting the Fraser Institute
Purpose, funding, & independence About the Fraser Institute Editorial Advisory Board / / 73 74
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The Fraser Institute’s Provincial Healthcare Index 2013 uses publically available data for the year 2010 (or the most recent year available) to measure the provision of healthcare in comparison to healthcare expenditures across provinces in Canada. The value for money that provinces receive can be thought of as consisting of two, equally important parts:  provision of healthcare (the value) and  expenditure on healthcare (the cost). The provision of healthcare is captured using 46 indicators, aggregated into four broad components:  availability of resources;  use of resources;  access to resources;  clinical performance of medical goods and services in each province.
1 Availability of resources
The availability of adequate medical resources is perhaps one of the most basic requirements for a proper functioning healthcare system. This study uses 12 indicators to measure relative availability of resources in three categories: human resources, technology resources, and drug resources. Overall, the data indicate that the province of Quebec has the largest number of medical resources per capita, followed by New Brunswick and Newfoundland and Labrador. The lowest number of medical resources, relative to that found in other provinces, is available in Manitoba, followed by Saskatchewan and Prince Edward Island.
2 Use of resources
While measurement of the availability of medical resources is valuable, it does not provide us with information about their use. It is, thus, important to include as well a measure of the volume of healthcare services provided. This study uses 17 indicators to measure the volume of healthcare services provided in two categories: medical services (provided by
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family medicine physicians, medical specialists, and surgical specialists) and technology (or diagnostic imaging) services. Unfortunately, a measure of the use of pharmaceutical products and services was not included as data are not available. Overall, the data indicate that Ontario performs the largest number of services per capita among the types included in this analysis, followed by the provinces of New Brunswick and Alberta. The least number of services are provided by Prince Edward Island, British Columbia, and...
References: Canadian Institute for Health Information [CIHI] (2012c). Frequently Asked Questions. Canadian Hospital Reporting Project [CHRP]. , as of August 22, 2012.
World Health Organization [WHO] (2000). The World Health Report: Health Systems: Improving Performance. . Zelder, Martin (2000). Spend More, Wait Less? The Myth of Underfunded Medicare in Canada. Fraser Forum, Special Issue (August).
Barua, Bacchus (2013)
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