Hospital Outcome Assessment in Canada

Summary

The purpose of this project was to inform debate by providing Canadians with detailed information on the performance of the health care sector across the country. The researchers argued that while Canadians spend on average $600 million of tax-payer money on healthcare annually, there is very little transparent reporting on how that money is spent. Moreover, CIHI, the organization in charge of evaluating performance in health care, is controlled by the same people whose performance is being evaluated, representing a conflict of interest in reporting. AIMS proposed the development of a report card system for the health care sector, which would define appropriate measures of health outcomes, assess the system and report on their findings in order to better inform Canadians about health care spending.

Grant Outputs

Models for Hospital Reporting: A finger on the pulse – http://www.aims.ca/site/media/aims/HRC1.pdf

This report examines the question of health care reporting in Canada, and compares the current system of service delivery measurement and analysis with models from the United States and Europe. The report concludes that while the Canadian health care system is monitored by the Canadian Institute for Health Information (CIHI), there are several problems associated with the measures of reporting used by CIHI. The report concludes that the current regime of health services monitoring actually results in skewing data, rather than improvements in system quality. As such, they recommend more carefully chosen measures of performance, and an independent body to review Canadian health care.

Taking the Pulse: Hospital Performance Indicators from the Patient’s Perspective – http://www.aims.ca/site/media/aims/HRC2.pdf

This report suggests that the goal of measuring health care should be to allow patients and policymakers to make comparisons between healthcare centers, eventually leading to improvements in the quality of care. It recommends new indicators with more value for patient evaluation. These include the proportion of patients who experience appropriate or inappropriate wait times. The report recommends that outcomes of care should be made public, so that patients can measure recovery times or quality of life following treatment at different institutions.

What You Don’t Know Can Hurt You: Hospital performance indicators from the patient’s perspective – http://www.aims.ca/site/media/aims/CanHurtYou.pdf

This report shows that while the Canadian provinces have articulated their dedication to transparency and accountability in providing patients with health care information, the absence of transparency makes it nearly impossible to produce a “Report Card” on health care facilities. Though attempts were made to access service provision data from seventeen hospitals across the country, response rates were remarkably low. Further, most hospitals refused to allow the publication of their names alongside what data was made available. The report concludes that while patients’ rights to privacy remained paramount, there were areas where health service provision could be made much more transparent, such as publishing reports generated by the Canadian Institute for Health Information (CIHI).