Abstract
ver the past 10 years, total annual healthcare spending in Canada has increased by more than $10 billion. It reached $172 billion in 2008, or $5,170 per person, outpacing inflation and population growth annually. Even when adjusted for inflation, this escalation in public expenditures cannot fail to attract the attention of taxpayers and consumers alike (Canadian Institute for Health Information 2008). The Canadian government has expressed concern over funding increases allocated to healthcare that have failed to result in a measurable improvement in health status. As a consequence of this concern, across federal and provincial jurisdictions, we’ve seen growing interest in performance accountability – not just in healthcare but across the public sector as a whole. As healthcare costs mount, so do expectations for improvements in planning, delivery and evaluation of health services. The reality for most health providers is that the demand for services still outstrips the capacity to deliver care, so decisions must be made regarding how and where to allocate funds and resources more effectively. In the face of pressures for cost control and accountability, trustees and senior executives of health agencies expect to be better informed about how their organizations are fulfilling their mandate. Unfortunately, many organizations lack this essential information. Data resources are often inadequate to the task. Fragmented and inconsistent data sources abound, often degraded by significant data quality problems. Unresolved anomalies among data sets and poor conformance to standards make benchmark comparisons difficult. In addition, much of these data are historical and only support demand-based planning rather than needs-based planning. Immediacy and urgency tend to characterize issues that arise in healthcare, with a resultant tendency toward a reactive management style. Because available information is typically limited and historical in nature, management finds itself attempting to solve tomorrow’s challenges with yesterday’s information.
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