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With improved access and timeliness to medical appointments, accompanied by reduced cost barriers for pharmaceutical, dental and homecare, Canada would rank above the international average and place 3rd in the ranking

Canada and its Provinces Fall Short When it Comes to Seniors’ Care


By C.D. Howe Institute ——--September 21, 2023

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September 21 - Canada and its provinces, specifically Newfoundland and Labrador and Quebec, can do more to improve access to seniors’ care and overall equity in the health system, a new E-Brief from the C.D Howe Institute shows.

In "Shortcomings in Seniors’ Care: How Canada Ranks Compared to its Peers and the Paths to Improvement,” authors Rosalie Wyonch and Tingting Zhang use data from the Commonwealth Fund, a major US Foundation, to better understand how Canada’s health system is doing in relation to seniors’ care, and what areas can be improved. They found that Canada currently ranks 8th out of 11 developed countries.

The study shows that the top-performing countries overall are Germany, Australia and Switzerland, and that Canada falls below the international average due to poor access to care and equity but meets the international average for care processes. While four provinces (PEI, Ontario, Manitoba and Alberta) score above the international average overall, improving equity and reducing wait times and cost barriers should be a priority across the country. Some provinces, particularly Newfoundland and Labrador and Quebec score below most international comparators and also need to prioritize improving care processes.

“We can see through an international comparison that top-performing countries such as Germany and the Netherlands rely on things like universal coverage, which includes primary care and treatments for chronic conditions, and are achieving better and more equitable health outcomes,” the authors state, also pointing to the fact that high-value services are more equitably available in those countries than in Canada. “Germany and the Netherlands also invest in home care, which encourages seniors to live independently for as long as possible.”

In Canada, most provinces exceed the international average in care process, which includes factors such as coordination across providers and patient engagement, but fall below average on access to care and equity.


Access to medical care is also an obstacle for low-income seniors. “We’re seeing that 15 percent of seniors in Canada are not visiting a dentist, and 8 percent are not receiving the home care they need due to cost. Addressing access gaps in home care and dental should be priorities for government,” Wyonch and Zhang conclude.

Among their policy recommendations, Wyonch and Zhang suggest improving overall access, timeliness of care and reducing cost barriers to prescriptions, dentistry and home care services.

“With improved access and timeliness to medical appointments, accompanied by reduced cost barriers for pharmaceutical, dental and homecare, Canada would rank above the international average and place 3rd in the ranking.”

For more information, please contact Rosalie Wyonch, Senior Policy Analyst at the C.D. Howe Institute, Tingting Zhang, Junior Policy Analyst at the C.D. Howe Institute and Gillian Campbell, Communications Officer, at gcampbell@cdhowe.org.


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C.D. Howe Institute—— The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. Widely considered to be Canada's most influential think tank, the Institute is a trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review.

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