How healthy is our health care system?

Access to doctors and treatment. Safe, quality care. Value for money. Better outcomes.

These are the health system issues that Canadians say matter most to them, time and time again. These and fairness—making sure those who need quality care can get it, no matter their income.

Meanwhile, organizations across Canada are making concerted efforts to collect data on a wide range of subjects; access, quality of care, return on investment, and patient outcomes are only some of what they’re encompassing. It’s a valuable exercise for people who work in the system, as they can use the data to measure, evaluate and improve performance…  and patient care.

What’s been missing, however, is something that distills comprehensive data specifically for the public. A resource that presents meaningful information concisely to give Canadians a snapshot on the health of the health system. Is there somewhere that people can go, for example, to find out how their health system is doing at the local level? Is it possible to learn how well different parts work together—or not—to meet the needs of patients? Can we compare how Canada’s health system stacks up to other countries? Could all this information be available in one place?

The answer is “Yes. We can now get a more comprehensive picture of how we are doing at” Launched in November, this new website was developed with the public in mind by the Canadian Institute for Health Information (CIHI). It uses clear language and appealing infographics to guide visitors through a virtual cross-country journey of the health system, comparing performance across Canada at various levels—by province, by region and, in some cases, even by hospital. Patients and health care professionals alike have already found it valuable. The media responded positively as well, with one daily newspaper referring to the site as “a treasure trove of information.”

For the people, by the people

As users and funders of the health system, Canadians want and deserve to know how well it’s performing. So CIHI set out to build a website that would focus on the areas of the health system that the public said was of greatest interest.

How? We started the project with a robust public consultation process, engaging more than 3,000 people from across the country through a combination of online randomized sampling and in-person small-group dialogues. This eventually led to the engaging and user-friendly site reflecting five health care themes, those identified as top-of-mind for Canadians.

Interwoven with these themes is the underlying but equally important issue of equity: Canadians receiving care based on clinical need, regardless of disparities in age, sex or socio-economic status. Within the five identified themes, the site shows that there are mixed results in terms of Canada’s health system performance: it’s doing well in some areas, but improvements are still needed in others.

Access: Can you get the health services you need, when you need them? 

  •  1 in 6 Canadians waits three months or longer to see a specialist—even though the number of specialists has increased since 2003.

Quality of Care: How good is the care you are receiving and is it safe? 

  • A significant drop in hospital deaths suggests that the quality of hospital care is improving overall in Canada; however, 1 in 12 Canadians is readmitted to hospital within 30 days of discharge and national results are not improving.

Spending: How much do the health services you use cost the system? 

  • Spending on health care varies greatly across the country, even after taking age differences in the population into account.

Health promotion and disease prevention: How well is the system working to help you stay healthy and avoid getting sick? 

  • While smoking rates are declining in Canada, obesity rates continue to rise. Obesity rates for children have tripled in the last 30 years.

Health outcomes: Are Canadians actually getting healthier? 

  • Three out of four Canadian children are developing well before entering Grade 1.

Using these themes as a cornerstone, builds on previously released data by combining it with new information. It features 15 comparable indicators— or measures of health system performance—that show performance from the national level down to the local and facility levels. Some examples:

• How many patients have repeat hospital stays for mental illness

• The number of residents in long-term care facilities who are taking anti-psychotic drugs without a diagnosis of psychosis

• The percentage of deaths in Canada that are from preventable or treatable causes

• How long people can expect to live based on their province or territory of residence

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See. Know. Share.

CIHI’s way of making health indicators more understandable, meaningful and useful is through the use of infographics on the site. Each health care theme is represented with an icon. Clicking on the icon, visitors can browse through sub-categories to explore and compare further.

The “Spending” icon, for example, is broken down into “Age-adjusted public spending per person” and “Average Cost of a hospital stay.” To involve visitors further and to encourage the distribution of knowledge, the site also allows visitors to easily share what they’ve learned through social media channels.

Where we go from here is just one of several steps in providing the public with more accessible information about its health system. In 2014, CIHI plans to release more performance measures for regions and hospitals in a similar website. This will replace the Canadian Hospital Reporting Project (CHRP) site at, and provide details of particular use to people working in the system.

We will also host a national consensus conference to bring together stakeholders for a discussion on future priorities as we plan to undertake even more performance reporting and indicator development.

In the meantime, is intended to serve as a reference to support better decisions and enhance transparency of the health system overall. And to keep the information timely and relevant, CIHI’s goal is to update the site at least once per year. This will help ensure the new website not only continues to be of interest to the public, but also useful for planners and policy-makers within the health care system. After all, it is especially important for them to understand who is doing well to best position them all for an even more efficient, high-quality system.

To learn more about Canada’s health system performance and see all of the results, please visit