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Webbased Archive of RIVM Publications > Articles and other publications by RIVM employees > Public Health and Health Care > Correlates of health and healthcare performance: applying the Canadian health indicators framework at the provincial-territorial level


Please use this identifier to cite or link to this item: http://hdl.handle.net/10029/10706
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Title: Correlates of health and healthcare performance: applying the Canadian health indicators framework at the provincial-territorial level
Authors: Arah, OA
Westert, GP
Citation: BMC Health Serv Res. 2005; 5: 76.
Publisher: BMC
Issue Date: 1-Dec-2005
URI: http://hdl.handle.net/10029/10706
DOI: 10.1186/1472-6963-5-76
Abstract: Background Since, at the health system level, there is little research into the possible interrelationships among the various indicators of health, healthcare performance, non-medical determinants of health, and community and health system characteristics, we conducted this study to explore such interrelationships using the Canadian Health Indicators Framework. Methods 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. Results 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. Conclusion 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.
Type: Article
Language: en
Appears in Collections:  Public Health and Health Care

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