HealthcarePapers
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This commentary by Victorian Order of Nurses Canada, written in response to "Getting What We Pay For? The Value-for-Money Challenge," by McGrail, Zierler and Ip, answers four key questions about Canada's home and community care sector: (1) What are our objectives? (2) Where do we achieve good value now? (3) Where and why are we failing? and (4) What will help us do better? We conclude that although the home and community care sector offers great promise in meeting the evolving health and social needs of Canadians, it is not living up to its potential. We propose the development of a national, integrated approach to home and community care to help Canadians remain healthy and independent in their homes. This would represent a wise financial investment for governments and would contribute to the long-term health of Canadians.
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In 2008, Canada spent $172 billion on healthcare, more than $5,000 for every man, woman and child in the country. Canada has one of the longer life expectancies in the Organisation for Economic Co-operation and Development and relatively low (and declining) amenable mortality rates. This suggests that the healthcare system is having some positive effect; but how well do we know what is "right" and what needs improvement? What do we get for the money we spend on healthcare? This paper proposes that there are some basic issues to address before these value-for-money questions can be answered. What do we value, or what do we want to achieve with our healthcare spending? Are we using inputs such as human resources well to provide services? Are we using services well to promote health? How would we know? The paper ends with a series of challenges to healthcare managers and decision-makers: to re-establish a broad information strategy, to include research as an integral part of healthcare delivery, to develop new data that can tell us something about outcomes of care and to articulate more formally objectives for the healthcare system.