Improving health system efficiency in Canada: a conceptual framework

At CIHI, we like to promote the idea of learning from each other. Our Canadian Population Health Initiative team recently applied this idea by engaging with decision-makers from British Columbia and Nova Scotia to learn about the main actions they have taken and the main challenges they face in improving health system efficiency. This qualitative study is the third and final phase of our health system efficiency project.

What affects efficiency?

Health system leaders broadly agreed that health system efficiency improvements depend on strong leadership yet can be constrained by factors in the external environment. The actions they’re taking to improve efficiency fall within 5 broad dimensions:

  • Performance monitoring for accountability and decision-making
  • System-level integration in governance and care delivery
  • Partnerships outside the health sector to improve population health
  • Physician engagement and remuneration
  • Flexible funding

Decision-makers found that these 5 areas, and the challenges faced in making improvements within them, provide some insight into the reasons why some health regions have been able to make more progress in improving efficiency than others.

Conceptual framework for improving health system efficiency

Why did CIHI do this study?

CIHI’s mandate is to improve health and health care. And nearly all jurisdictions have publicly stated goals to improve efficiency or value for money in their health systems. The framework developed from this study can be applied to any jurisdiction to assess or compare progress toward improving efficiency.

“Improving health system performance and getting better value from the money spent in health care continue to dominate the health policy landscape,” explains Sara Allin, a senior researcher with the CPHI team and one of the authors of the report. “Public discourse continues to shift from increasing health system resources toward optimizing these resources. We hope this work sheds some light on the complex topic of efficiency in Canada and helps regions to develop and initiate strategies to improve their efficiency at a local level.”

Learn more in our newly released report Improving Health System Efficiency in Canada: Perspectives of Decision-Makers.