New research finds 'clear misalignment' between what Canadians value, and health system performance measurement and funding

Nov 27, 2012, 06:00 ET from International Centre for Health Innovation

TORONTO, Nov. 27, 2012 /CNW/ - There is a clear misalignment between what Canadians value from a health perspective, and how health system performance is measured and funded, according to new research presented today by the International Centre for Health Innovation (the Centre) at the Richard Ivey School of Business. To achieve greater value for health system costs in Canada and achieve transformational change, the paper suggests that the values of Canadians and those that underpin health systems must align.

"The research findings confirm that Canadian values related to health care have shifted in recent years towards a desire for greater autonomy and empowerment in managing their wellness and health," said Dr. Anne Snowdon, Chair of the Centre. "This means Canadians want a health care system focused on quality of life, health and wellness, and one in which the patient is the core priority, yet we have health care systems that are funded and measured based on an entirely different set of criteria."

The study identifies in detail the misalignment between Canadians' values and how the system is currently designed, organized, funded, and evaluated. For example, the values of Canadians are not currently captured in health system costing data or funding models. Health system costs are focused on the "inputs" of Canadian health systems (i.e., cost of drugs prescribed, cost of hospital services) and are not associated with outcomes of health systems that may reflect or align with Canadian values. In addition, current measures of health system performance focus primarily on access to care, and quality outcomes that identify hospital-related adverse events. Health systems rely on performance measures in terms of safety, and risk associated with hospitalizations. There is very little evidence that Canadians' values are represented in the current performance measurement or evaluation frameworks.

"Further, our analysis of the values of each of the comparator OECD countries varied widely from Canadian health systems values. Values expressed in the comparator OECD countries tend to focus more directly on healthy, active living, patient choice, and health literacy, a stark contrast to Canadian health systems values," added Dr. Snowdon. "These OECD countries have also achieved greater quality outcomes in their health systems. As a country we have not focused on healthy, active living as a priority."

To successfully shift the Canadian health care system to one that is cost-effective, sustainable, and patient-centric, the Centre recommends the following:

  1. Align health system values with Canadian values, in order to develop a system that is focused on strengthening health and quality of life for the Canadian population.
  2. Align health system performance metrics and funding models with Canadian values, focusing on health and wellness as a central mandate.
  3. Re-examine health workforce values relative to the needs and values of Canadians, who strive for personalized and collaborative relationships with health providers to achieve health and wellness.

"In order to achieve the effective, sustainable and patient-centric model of health care in Canada, the values of Canadians and those of the health care system must align," said  Snowdon. "Canadians' values reflect the desire for a more 'personalized' health care system, one that actively engages consumers in a collaborative partnership with health providers. This shift is essential to achieving transformational change within our health system."

To access a PDF version of the full white paper, visit:

SOURCE International Centre for Health Innovation