Measuring Outcomes in the Canadian Health Sector: Driving Better Value from Healthcare

While Canada has a well-established tradition of transparency and accountability for health-system performance comparisons, few measures of outcomes are reported. In this Commentary, we examine what outcomes measurement is; the state of outcomes measurement in Canada; and offer recommendations so that the generation of better information on health system outcomes can help achieve greater value in the health sector. Outcome measures help to better understand how effectively the health system achieves its goals, support better decision-making by relating investment decisions to outcomes, and better match the delivery of health and social services to the evolving needs of populations and patients. From a research perspective, outcome measures help better understand how policy interventions and healthcare services can contribute to achieving targeted outcomes and their role in the broader social determinants of health. And from a democratic perspective, publicizing outcome measures can empower patients, families and communities to engage in the policy debate about which outcomes matter most and at what cost – and in the ways healthcare should be delivered. Among our key recommendations: • The federal and provincial governments should complement current data with outcome measures of relevance to patients, clinicians, system managers and policy practitioners. In particular, patient-reported outcome measures and patient reported experience measures should augment datasets currently available in panCanadian clinical registries. • Organizations with a mandate to report publicly on health-system performance, such as the Canadian Institute for Health information and provincial health quality councils, should collect outcomes data and report publicly on outcomes, filling current gaps in outcomes measurement and public reporting. The ultimate yardstick of success, however, will not be the quantity and accuracy of Canadian healthcare outcomes data, but rather how this information is put to use by clinicians, system managers and policymakers to advance health system goals. Better measurement can only take us so far. More critical is how the data will be aggregated, analyzed, risk-adjusted and, most importantly, how public policy and other interventions will incent professionals to improve outcomes and patients to demand better outcomes and value from the healthcare sector.