Health Council of Canada releases 2011 Commonwealth Fund International Health Policy Survey results

Sicker Canadians with chronic conditions face many barriers to the health care they need

TORONTO, December 12, 2011 /Canada NewsWire/ - Today, the Health Council of Canada released results from the 2011 Commonwealth Fund International Health Policy Survey. The bulletin How Do Sicker Canadians with Chronic Disease Rate the Health Care System? compares experiences of sicker Canadians with chronic conditions to those of the general public.

Sicker Canadians report using more health care services than the general population. They are more likely to be hospitalized, have surgery, use emergency departments and take prescription medication compared to the general public. Most of this group is 50 years of age or older, but 34% are adults under the age of 50.

Along with being more frequent users of the health care system, sicker Canadians report experiencing considerable barriers to accessing the health care they need. Cost being one of the major barriers. Almost a quarter (23%), said they skipped a dose of medication or did not fill a prescription due to cost, compared to just 10% of the general population. This is a significant number since 90% of sicker Canadians take at least one prescription drug, and 54% take four or more. In addition, one in eight (12%) respondents have skipped a recommended test of follow up treatment due to cost concerns, compared to just 5% of the general population.

Sicker Canadians are more likely (59%) to have below average household income and lower levels of education than the general population. This means that in addition to primary costs for care and medication, secondary costs like travel to appointments, child care and time away from work can create obstacles to accessing care. In fact, 12% of sicker Canadians reported not visiting a doctor due to cost concerns, compared to just 4% of the general population. Over a quarter of health care services in Canada are paid for through private sources, be it out-of-pocket by patients or through private insurance.

"The experiences of patients with chronic conditions can tell us a lot about the quality of the health care system as a whole and the progress we have made," said John G. Abbott, CEO, Health Council of Canada. "The data here tells us, we need to be concerned that there are many Canadians who still cannot afford treatment of their chronic conditions. We need to address this immediately, because medications that prevent complications from chronic disease are vital in contributing to better quality-of- life for individuals, and reduced health care costs for the system. "

The survey also shows that sicker Canadians fare worse when it comes to coordination of their care. People with chronic conditions are likely to see multiple care providers and specialists, yet fewer said they always received help from their doctor's office in coordinating other care they need.

In addition, sicker Canadians felt less engaged in their health care than the general public. Only 64% felt their doctors explained things in ways that they could easily understand, and even fewer (55%) felt they had enough time with their doctor. "We need to help sicker Canadians feel more engaged, because we know that more engaged patients perceive themselves to be healthier and make better use of the health services and resources in the system," said Abbott.

"It's important that my doctors know my medical history and are up to speed on my health results," said Frank Austin, a stroke survivor and patient advocate. "There needs to be improved communication among health care providers so that time is not wasted and the risk of errors in my care is reduced."

However, there were some positive results from sicker Canadians; more had a regular doctor or clinic where they went for care (96% compared to 86% of the general population). They also found it easier to get care after-hours or to get an appointment with a doctor the same or next day. While these results are promising, overall, the results indicate that we certainly have work to do.

The report provides recommendations on how to eliminate cost barriers for prescription drugs and also barriers that prevent patients from following up on recommended tests and treatments. The report looks at alternatives to face-to-face visits - like telemedicine, email and phone consultations - for saving costs on travel time and resources. To improve coordination of care, electronic medical records can be an important tool and are long overdue in Canada. The report also calls for doctors, policy makers and patients to work together to find solutions that increase patient engagement and involvement in their care.

About the Survey

The 2011 Commonwealth Fund International Health Policy Survey reflects the perceptions of a random sample of about 19,000 adults across 11 OECD countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Participants, including 3,958 Canadians, were interviewed by telephone between March and June 2011. The Health Council of Canada sponsored a portion of this study along with the Alberta Health Quality Council, Health Quality Ontario, and the Quebec Health and Welfare Commissioner (Commissaire à la santé et au bien-être du Québec).

About the Health Council of Canada

Created by the 2003 First Ministers' Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on leading practices and innovation across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.

To download reports and other Health Council materials, visit