This presentation was given on May 20, 2011, as an overview of healthcare in Canada to a group of American Congressional Fellows on Parliament Hill. The Fellows were in Canada on an official visit, sponsored by the Department of Foreign Affairs and International Trade Canada (DFAIT), as part of an exchange with the Parliamentary Internship Programme. The group included 20 mid- to senior career professionals from various departments in the American and some foreign Governments, professors from American universities and journalists. They also include a number of Robert Wood Johnson Foundation Fellows, who are all medical professionals.

7. Lavis J. et al. 2009. SUPPORT Tools for evidence-informed health Policymaking (STP) . Health Research Policy & Systems 7(Suppl 1). http://www.health-policysystems.com/content/7/S1/I1

8. History & Roles Healthcare in Canada

20. Financing & Cost Drivers Healthcare in Canada

21. Total health expenditure per capita, US$ PPP Source: Public Accounts and 2000 budgets.

22. Source: OECD Health Data 2010. (latest data 2008) INDICATOR CANADA US OECD Average Total Health Expenditures as a % of GDP (32) 10.4 (6 th ) 16.0 (1 st ) 9.0 Total Health Expenditures Per Capita US $ (27) $4,079 (5 th ) $7,538 (1 st ) $3,060 Public % of Total Health Expenditures (31) 70.2 46.5 72.8

29. What are the key cost drivers?

30. The effect of key cost drivers on health spending growth: - Synthesis of Canadian studies

31. Quality & Performance Healthcare in Canada

32. Source: Adapted with permission from Accreditation Canada (2007). “Quality Frameworks: National and International Overview, Common/Unique Dimensions & Key Messages” Note: Shaded rows indicate common dimensions across all organizations. Kelley, E. and Hurst, J. (2006). Health Care Quality Indicators Project: Conceptual Framework Paper. OECD Health Working Papers. BC Patient Safety and Quality Council. (2009). BC Health Quality Matrix. www.bcpsqc.ca Health Quality Council of Alberta. (2009). Alberta Quality Matrix for Health. www.hqca.ca Saskatchewan Health Quality Council. (2009). Quality Insight—Dimensions of Quality. www.hqc.sk.ca Ontario Health Quality Council. (2009). 2009 Report on Ontario’s Health System. www.ohqc.ca LSSS, L.R.Q., chapitre S‐4.2 Loi sur les services de santé et les services sociaux. www.publicationsduquebec.gouv.qc.ca New Brunswick Health Council (2009). Quality Dimensions. www.nbhc.ca Most frequently used dimensions internationally¹ Quality dimension Accreditation Canada B.C. PSQC² HQCA³ SHQC⁴ OHQC⁵ Province of Quebec 6 NBHC 7 Acceptable ■ ■ ■ X Accessible/ Timely ■ ■ ■ ■ ■ ■ ■ X Appropriate ■ ■ ■ ■ Appropriately resourced ■ Competence ■ Continuity ■ ■ ■ X Effective ■ ■ ■ ■ ■ ■ ■ X Efficient ■ ■ ■ ■ ■ ■ ■ X Equitable ■ ■ ■ ■ Integrated ■ Patient/Client centred ■ ■ ■ ■ ■ Population Health ■ ■ ■ ■ X Safe ■ ■ ■ ■ ■ ■ ■ Work life ■ ■

37. Final points Healthcare in Canada

40. Visit us at w ww.chsrf.ca or email [email_address] [email_address] Thank You