As Canada’s population ages at a rapid pace, a new study from the CD Howe Institute suggests the country can do more to improve access to senior care and overall equity in the health care system.
The study, released Thursday, compares the performance of senior care in Canada and its provinces with that of other wealthy countries, using data from the Commonwealth Fund, a U.S. foundation dedicated to improving health care systems, and identifies areas for improvement.
The International Health Policy Foundation’s 2021 Survey of Older Adults targeted a random sample of seniors aged 65 and older in 11 developed countries and asked about their experiences, interactions and perceptions of the health care system and health care providers.
Among the countries surveyed, Canada ranked eighth in care for the elderly — ahead of only France, the United Kingdom and Sweden.
AREAS OF STRENGTHS, WEAKNESSES
The CD Howe Institute study draws on survey data and applies a magnifying lens to senior care in Canada’s provinces because, as study co-author Rosalie Wyonch explained in an interview with CTVNews.ca, “we’re really 13 health professionals. systems, not one.”
The study found that most provinces exceed the international average in the process of care, which includes factors such as coordination between health care providers and patient engagement, but fall short of the average in equity and access to care, which includes factors such as waiting times.
He also notes that access to medical care is a barrier for low-income seniors, noting in a study that 15 percent of Canadian seniors don’t see a dentist and eight percent don’t get the home care they need because they can’t afford it.
Four provinces – PEI, Ontario, Manitoba and Alberta – were found to score above the international average overall, while some provinces – notably Newfoundland and Labrador and Quebec – scored below most international benchmarks.
Among their policy recommendations, Wyonch and her co-author Tingting Zhang suggest improving overall access to senior care, timeliness of care, and reducing cost barriers to prescription, dental, and home care services across the country.
“Part of the analysis is how can we push ourselves to be the best of the best?” said Wyonch, who is also a senior policy analyst at the CD Howe Institute and leads its Health Policy Council and Research Initiative.
“And so we would do better to reduce wait times and ensure that especially those at the bottom of the income distribution have access to care.”
INTERNATIONAL EXAMPLES
The study also analyzed countries such as Germany and the Netherlands, which rank higher than Canada in senior care, to draw inspiration for domestic solutions.
Wyonch notes that the Netherlands stands out as “significantly better” in terms of access to after-hours care than other countries and Canadian provinces.
This, she says, is due to the fact that doctors in the Dutch country must complete at least 50 hours of out-of-hours care each year to maintain their licenses.
Germany, on the other hand, reported the highest health status among the elderly.
“Because they’re actually better at keeping their population healthy and doing better prevention, so they’re healthier to begin with. So they require less care and that helps with the problem of access and waiting time,” Wyonch explained.
CANADA SHOULD NOT BE ‘SATISFIED’: STUDY AUTHOR
The federal government projects that the population of seniors, or people aged 65 and over, will grow to nearly one-quarter of Canada’s total population by 2040.
Wyonch said this is likely to put additional pressure on Canada’s health care system, further fueling the country’s need to prioritize care for seniors.
“The need for care is only going to increase in the coming years, at least over the next few years, before the demographic curve shifts back in the other direction,” she said.
“But during that time, we have to prepare to be able to provide that care or when people need it in the future, because adapting systems, building buildings, training doctors — most things take years.”
The COVID-19 pandemic, which has exposed cracks in the country’s health care system, including senior care, and claimed the lives of thousands of seniors, is another reason to be proactive rather than “complacency,” Wyonch said.
“Decades of warning culminated in the disaster that was the institutional care pandemic. And so we had a lot of prior knowledge and in my opinion we haven’t done enough to prevent something like this from happening,” she said.
“Most actions in the health care system will necessarily take effect several years into the future. And so if we want to deal with these things before there is a crisis, we should act sooner rather than later.”
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