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The determinants of efficiency in the Canadian health care system

Published online by Cambridge University Press:  07 May 2015

Sara Allin ,
Michel Grignon  and
Li Wang
Sara Allin*
Affiliation:
Canadian Institute for Health Information, Toronto, ON, Canada University of Toronto, Toronto, ON, Canada
Michel Grignon
Affiliation:
McMaster University, Hamilton, ON, Canada
Li Wang
Affiliation:
Canadian Institute for Health Information, Toronto, ON, Canada McMaster University, Hamilton, ON, Canada
*
*Correspondence to: Sara Allin, Senior Researcher, Canadian Institute for Health Information (CIHI), 4110 Yonge Street, Suite 300, Toronto, ON M2P 2B7, Canada. Email: sallin@cihi.ca
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Abstract

In spite of the vast number of studies measuring economic efficiency in health care, there has been little take-up of this evidence by policy-makers to date. This study provides an illustration of how a system-level study drawing on best practice in empirical measurement of efficiency may be of practical use to health system decision makers and managers. We make use of the rich data available in Canada to undertake a robust two-stage data envelopment analysis to calculate efficiency at the regional (sub-provincial) level. Decisions about what the health system produces (the outcome to measure efficiency against) and what are the resources it has to produce that outcome were based on interviews and consultation with health system decision makers. Overall, we find large inefficiencies in the Canadian health care system, which could improve outcomes (here, measured as a reduction in treatable causes of death) by between 18 and 35% across our analyses. Also, we find that inefficiencies are the result of three main sets of factors that policy makers could pay attention to: management factors, such as hospital re-admissions; public health factors, such as obesity and smoking rates; and environmental factors such as the population’s average income.

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Articles
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Health Economics, Policy and Law , Volume 11 , Issue 1 , January 2016 , pp. 39 - 65
Copyright
© Cambridge University Press 2015 

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