November 23, 2011—Canada’s health system has mixed results in comparison with its peers in the Organisation for Economic Co-operation and Development (OECD), according to a new report released today by the Canadian Institute for Health Information (CIHI).
Learning From the Best: Benchmarking Canada’s Health System examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, also being released today, which provides the latest statistics and indicators for comparing health systems across 34 member countries.
Interpreting results requires caution, however, because of factors such as data quality and comparability of definitions across countries.
“Canada’s data may be more complete and accurate than that of some other OECD members,” explains CIHI’s Vice President of Research and Analysis, Jeremy Veillard. “Even so, international comparisons can highlight potential areas of improvement for our own health system.”
While Canada has lower smoking rates than most OECD countries, rates of obesity and overweight are among the highest.
Having made remarkable progress in the prevalence of smoking, Canada is one of only five OECD countries that decreased its smoking rate by more than 30% since 1999. It is virtually tied with the U.S. for the lowest rate of adult smokers among G7 countries (16.2% for Canada and 16.1% for the U.S.).
In contrast, adult Canadians’ self-reported rate of obesity (16.5%) places it as the second-highest of the G7 countries (G8 countries excluding the Russian Federation, which is not a member of the OECD). Self-reported obesity is the most commonly available information internationally, but studies have shown that people often significantly underestimate their weight. Actual measurements suggest that our rate is 24.2%, which is less than the U.S.’s 33.8% and more in line with the U.K.’s 23%.
More than 25% of Canadian boys and girls are overweight. Canada is one of only three G7 countries (along with Italy and the U.S.) where the prevalence of overweight is above 25% for both groups.
CIHI’s analysis shows that Canada performs relatively well in screening and survival rates for cancer. While five-year survival results were close to the OECD average for cervical cancer, they were above average for colorectal cancer and behind only the U.S. and Japan for breast cancer.
However, despite these successes, cancer deaths remain relatively high in Canada, due primarily to a higher incidence of cancer, in particular of cancers that are difficult to screen for and treat early, such as lung cancer. This was especially true in women—cancer mortality rates for females in Canada are among the highest in the OECD and the highest among G7 countries.
“Canada has strong performance in cancer diagnosis and treatment. Reducing cancer deaths further may require more focus on prevention programs to reduce the number of new cases,” says Kathleen Morris, Director of Health System Analysis and Emerging Issues at CIHI. “For example, lower smoking rates in Canada today may mean fewer lung cancer cases in the future—but some of this progress could be offset by higher obesity rates, which are also a risk factor for cancer.”
Canada is in or close to the top 25% of OECD countries on many measures of quality of care. For example, Canada has lower rates of hospital admissions for certain chronic conditions that can be managed by good primary care in the community. This includes the second-lowest rate among OECD countries—and the lowest rate among G7 countries—for asthma admissions and a better-than-OECD-average rate for admissions related to chronic obstructive pulmonary disease.
Canada also had the best rate among G7 countries for admissions for uncontrolled diabetes (which can also be managed by good primary care) despite having a prevalence of diabetes that is among the highest in the OECD.
However, national results for some patient safety measures did not compare as favourably: Canada had some of the highest rates among 17 reporting countries of accidental puncture or laceration, as well as of foreign bodies left in during surgical procedures. It also had among the highest rates of obstetrical trauma of 20 countries reporting.
“Patient safety is a priority area for both the Canadian health system and the public. Canada’s results show it still has a lot of work to do in this area,” explains Mr. Veillard. “However, what is not so clear is how we really measure up internationally, as adverse events may not be reported as consistently in other countries as they are here.”
CIHI and Statistics Canada maintain the Canadian segment of the OECD Health Database, contributing national data on health care spending, health care services and the health status of the population. Most Canadian data originates from databases maintained by these two organizations, such as CIHI’s health expenditures, health services and health professionals databases and the demographic and vital statistics databases at Statistics Canada.
Established in 1994, CIHI is an independent, not-for-profit corporation that provides essential information on Canada’s health system and the health of Canadians. Funded by federal, provincial and territorial governments, CIHI is guided by a Board of Directors made up of health leaders across the country. Our vision is to improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.