%0 Journal Article
%T Correlates of health and healthcare performance: applying the Canadian health indicators framework at the provincial-territorial level
%A OA Arah
%A GP Westert
%J BMC Health Services Research
%D 2005
%I BioMed Central
%R 10.1186/1472-6963-5-76
%X We conducted univariate correlational analyses with health and healthcare performance as outcomes using recent Canadian data and the ten Canadian provinces and three territories as units of the analyses. For health, 6 indicators were included. Sixteen healthcare performance indicators, 12 non-medical determinants of health and 16 indicators of community and health system characteristics were also included as independent variables for the analysis. A set of decision rules was applied to guide the choice of what was considered actual and preferred performance associations.Health (28%) correlates more frequently with non-medical determinants than healthcare does (12%), in the preferred direction. Better health is only correlated with better healthcare performance in 13% of the cases in the preferred direction. Better health (24%) is also more frequently correlated with community and health system characteristics than healthcare is (13%), in the preferred direction.Canadian health performance is a function of multiple factors, the most frequent of which may be the non-medical determinants of health and the community characteristics as against healthcare performance. The contribution of healthcare to health may be limited only to relatively small groups which stand to benefit from effective healthcare, but its overall effect may be diluted in summary measures of population health. Interpreting multidimensional, multi-indicator performance data in their proper context may be more complex than hitherto believed.In June 2000, in its ambitious comparison of 191 countries in terms of their ability to meet three main goals ¨C improving health, increasing responsiveness to meet the legitimate demands of the population, and ensuring that financial burdens are distributed fairly ¨C the World Health Organization (WHO) ranked Canada 30th in overall health system performance [1]. This was considered a further blow to an already shaken collective psyche in Canada [2]. Canada, which WHO
%U http://www.biomedcentral.com/1472-6963/5/76