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IHE In Your Pocket 2014

A Handbook of Health
Economic Statistics
Chair
Dr. Lorne Tyrrell (Board Chair), CIHR/GSK Chair in Virology, University of Alberta
Government and Other
Ms. Janet Davidson, Deputy Minister, Alberta Health
Mr. David Morhart, Deputy Minister, Enterprise and Advanced Education
Dr. Cy Frank, Chief Executive Ofcer, Alberta Innovates Health Solutions
Mr. Duncan Campbell, Acting President and CEO, Alberta Health Services
Academia
Dr. Rene Elio, Associate Vice-President (Research), University of Alberta
Dr. Jon Meddings, Dean, Faculty of Medicine, University of Calgary
Dr. Douglas Miller, Dean, Faculty of Medicine & Dentistry, University of Alberta
Dr. Edward McAuley, Vice-President Research, University of Calgary
Dr. James Kehrer, Dean of Pharmacy, University of Alberta
Dr. Herb Emery, Professor, Department of Economics, University of Calgary
Dr. Doug West, Chair, Dept. of Economics, University of Alberta
Industry
Mr. Mark Findlay, Vice President, Cornerstone & Market Access, AstraZeneca
Ms. Lauren Fischer, Vice President, Corporate Affairs, Eli Lilly Canada Inc.
Ms. Jennifer Chan, Vice President, Policy & Communications, Merck Canada
Ms. Ghislain Boudreau, Vice President, Public Affairs, Pzer Canada Inc.
Mr. Grant Perry, Vice President, Public Affairs and Reimbursement, GlaxoSmithKline Inc.
IHE
Mr. Doug Gilpin, Chair, Audit and Finance Committee
Dr. Egon Jonsson, Executive Director & CEO, Institute of Health Economics
Ms. Allison Hagen, Board Secretary & Treasurer, and Director of Finance, Operations &
Administration, Institute of Health Economics
The Institute of Health Economics (IHE) is an independent,
not-for-prot organization that performs research in health
economics and synthesizes evidence in health technology
assessment to assist health policy making and best medical practice.
IHE Board members
IHE IN YOUR POCKET 2014
Institute of Health Economics
The Institute of Health Economics (IHE) is a non-prot
organization which provides research to support policy and
practice in a broad range of areas which impact on health,
including healthcare and public health, educational, legal and
other services. The IHE produces a large number of evaluations
within our health technology assessment and economic
modeling programs, along with other economic intelligence
studies that inform policy. The IHE also facilitates discussions
about current issues in health through a number of initiatives,
such as our series of Consensus Development Conferences,
Policy Forums, and targeted Knowledge Exchange Programs.
The secretariats of the main international organizations in the
elds of HTA are located within the Institute, namely, HTAi
(Health Technology Assessment International), and INAHTA
(The International Network of Agencies in Health Technology
Assessment).
INSTITUTE OF HEALTH ECONOMICS
IHE In Your Pocket was designed to provide a compact,
comprehensive, and comparative overview of the economic
aspects of the Canadian health care system. It has been revised
every second year since 2006.
As in the earlier editions, we have adopted a broad, population
health approach. We have substantially reorganized the
2014 edition. We divided data on the health care system
into components. For each component, we provide the
most important economic indicators which reect capacity,
investment, utilization, prices and costs, total expenditures and
nance, on the supply side; and population characteristics,
population behaviour, nance and indirect costs on the demand
side.
We hope that you like the current edition of IHE In Your
Pocket, and we would very much like to hear from you. If you
have comments or suggestions, please contact Philip Jacobs at
pjacobs@ihe.ca or call or write us at the IHE (info@ihe.ca).
IHE project staff for In Your Pocket 2014 included Philip
Jacobs, Jessica Moffatt, Jian Wang, Dagmara Chojecki and Don
Husereau. We obtained research assistance from Alison Pitcher,
and comments and data from John Abbott and Brett Skinner.
Introduction
IHE IN YOUR POCKET 2014
Table of Contents
Health care expenditures and cost of illness..... page 1
Hospital inpatient services ......................................... page 13
Physician services .......................................................... page 23
Other providers .............................................................. page 29
Continuing care and home care .............................. page 43
Pharmaceuticals .............................................................. page 51
Public health..................................................................... page 63
Health behaviors ............................................................ page 71
Health status..................................................................... page 79
Demographics ................................................................. page 83
Health system performance ...................................... page 91
INSTITUTE OF HEALTH ECONOMICS
Notes
Health Care Expenditures and
Cost of Illness
2 INSTITUTE OF HEALTH ECONOMICS
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Capital
Hospitals
Physicians
Drugs
Administration
Other professionals
Other health spending
Other institutions
Public health
Source: National Health Expenditure Trends, 1975 to 2012, Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1952 on August 30,
2013. www.cihi.ca
Health care expenditures
Canada, 2012
10.8%
5.8%
29.2%
3.1%
4.6%
15.9%
14.4%
10.7%
5.3%
Total health expenditure = $207.4 billion
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Hospital costs
Drug costs
Physician costs
Indirect costs
Source: Public Health Agency of Canada (2013) Economic Burden of Illness in Canada, 2005-2008,
unpublished.
Economic burden of illness,
eight most costly diseases
Canada, 2008, millions of dollars
Millions of dollars in each cost category
0 2000 4000 6000 8000 10000 12000
Neuropsychiatric
Cardiovascular
Injuries
Musculo skeletal
Digestive
Respiratory infections
Malignant neoplasns
Respiratory diseases
$3,506
$4,040
$4,921
$5,142
$6,310
$7,483
$11,071
$11,455
4 INSTITUTE OF HEALTH ECONOMICS
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0 3000 6000 9000 12000 15000
Nunavut
North West Territories
Yukon
Newfoundland
Alberta
Manitoba
Nova Scotia
Saskatchewan
Prince Edward Island
New Brunswick
Ontario
British Columbia
Quebec
Canada
Note: Forecast data; amount shown in 2010 CDN$ value.
Source: National Health Expenditure Trends, 1975 to 2012, Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/free_products/NHEXTrendsReport2012EN.pdf, Table 1.2 on
August 30, 2013. www.cihi.ca
Health care expenditures
per capita
Canada, 2012
Per capita spending in CDN$
$5,469
$5,700
$5,849
$5,948
$6,318
$6,336
$6,481
$6,497
$6,518
$6,754
$7,057
$8,916
$9,853
$13,250
5 IHE IN YOUR POCKET 2014
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0 2000 4000 6000 8000 10000
Switzerland
Norway
United States
Netherlands
Australia*
Canada
Sweden
France
Germany
Japan *
United Kingdom
Italy
Spain
In current US$
Notes: Data are in current US dollars. *2010 data.
Source: Health expenditure per capita (in current US$). The World Bank. Accessed at http://data.
worldbank.org/indicator/SH.XPD.PCAP/countries on September 10, 2013. www.worldbank.org
Health expenditures per
capita
selected OECD countries, 2011
$3,027
$3,436
$3,609
$3,958
$4,875
$4,952
$5,331
$5,630
$5,939
$5,995
$8,608
$8,987
$9,121
6 INSTITUTE OF HEALTH ECONOMICS
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0 5 10 15 20 25
Nunavut
Prince Edward Island
Nova Scotia
New Brunswick
Manitoba
Quebec
Yukon
Ontario
British Columbia
Newfoundland
Saskatchewan
Alberta
Northwest Territories
Canada
Health care expenditures as a
percentage of Gross Domestic
Product (GDP)
Canada, 2012
11.6
8.4
8.6
9.6
11.7
11.8
11.9
12.2
12.7
13.7
15.4
16
17.4
23.2
Percentage of GDP (%)
Source: National Health Expenditure Trends, 1975 to 2012. Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1952 on August 30,
2013. www.cihi.ca
Health expenditures as a percentage of Gross Domestic Product
Canada, 1975 - 2012
6
8
10
12
1
9
7
5
1
9
7
7
1
9
7
9
1
9
8
1
1
9
8
3
1
9
8
5
1
9
8
7
1
9
8
9
1
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9
1
1
9
9
3
1
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9
5
1
9
9
7
1
9
9
9
2
0
0
1
2
0
0
3
2
0
0
5
2
0
0
7
2
0
0
9
2
0
1
1
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4 8 12 16 20
United States
France
Netherlands
Switzerland
Germany
Canada
New Zealand
Austria
Japan*
Spain
United Kingdom
Norway
Italy
Australia*
Health care expenditures as a
percentage of Gross Domestic
Product (GDP)
selected OECD countries, 2011
8.5
8.7
8.9
9.1
9.1
9.5
10.2
10.3
10.6
11.0
11.0
11.1
11.2
17.0
Note: * 2010 data
Source: Health at a Glance, 2011. Organization for Economic Co-operation and Development.
Accessed at http://www.oecd.org/els/health-systems/49105858.pdf on August 30, 2013. www.
oecd.org
Percentage of GDP (%)
OECD Average: 9.6
8 INSTITUTE OF HEALTH ECONOMICS
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0 3000 6000 9000 12000 15000
Nunavut
Northwest Territories
Yukon
Newfoundland
Alberta
Manitoba
Nova Scotia
Saskatchewan
Prince Edward Island
New Brunswick
Canada
Ontario
British Columbia
Quebec
Source: National Health Expenditure Trends, 1975 to 2012, data tables. Canadian Institute for Health
Information. Accessed at https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1952 on
August 30, 2013. www.cihi.ca
Health expenditures by source
of nance
Canada, 2012
67.8%
68.7%
69.1%
69.3% (public sector)
69.3%
69.7%
72.5%
73.6%
73.9%
76.4%
76.5%
77.6%
85.3%
93.8%
% in Public Sector
% in Public & Private for Canada
% in Private Sector
Total health care expenditures (per cent public)
9 IHE IN YOUR POCKET 2014
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0 2000 4000 6000 8000 10000
United States
Switzerland
Norway
Germany
Austria
Canada
France
Sweden
Australia*
Japan*
Finland
New Zealand
Spain
Italy
Note: Data is expressed in US$, adjusted for purchasing power parities (PPPs), which provides a
means of comparing spending among countries on a common basis.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development. Population
and Purchase Power Parity information was from www.stats.oecd.org. Accessed at source: http://stats.
oecd.org/index.aspx?queryid=30163# on August 30, 2013; Accessed at source: http://stats.oecd.
org/index.aspx?DataSetCode=HEALTH_STAT#
Health care expenditures by
source of nance
selected OECD countries, 2011
$2,854.3 (80%)
$2,923.5 (72.9%)
$3,181.5 (82.7%)
$3,217.3 (75.3%)
$3,296.6 (81.9%)
$3,570.5 (68%)
$3,702.7 (81.6%)
$4,090.3 (77.2%)
$ 4,294.9 (69.9%)
$ 4,305.4 (77.3%)
$ 4,323.6 (77.0%)
$ 5,456.9 (84.9%)
$5,642.6 (64.9%)
$ 8,175.0 (48.8%)
Public sector nanced expenditures
Private sector nanced expenditures
US$ PPP percapita, per cent public
10 INSTITUTE OF HEALTH ECONOMICS
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Source: Provincial and territorial general government revenue and expenditures, by province and
territory. Statistics Canada. Accessed at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/
govt56a-eng.htm on Sept 26, 2013. www.statcan.gc.ca.
Percentage of total government
expenditures on health
Canada, 2009
Percentage of total government expenditures on health
0 5 10 15 20 25 30 35 40
Ontario
Nova Scotia
British Columbia
New Brunswick
Manitoba
Saskatchewan
Canada
Prince Edward Island
Newfoundland
Alberta
Quebec
Nunavut
North West Territories
Yukon
14.7%
20.3%
21.9%
27.8%
30.4%
31.8%
32.2%
33%
33.7%
34%
34.7%
35.2%
36.5%
38.6%
11 IHE IN YOUR POCKET 2014
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12 INSTITUTE OF HEALTH ECONOMICS
Notes
Hospital Inpatient Services
14 INSTITUTE OF HEALTH ECONOMICS
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0 1 2 3 4 5
Newfoundland and Labrador
Northwest Territories
New Brunswick
Manitoba
Saskatchewan
Prince Edward Island
Nova Scotia
British Columbia
Alberta
Canada
Ontario
Yukon
Note: Numbers represent both beds and cribs available in hospitals for the following uses: intensive
care, obstetrics, pediatrics, psychiatry, rehabilitation, long-term care, and other acute care. Quebec
and Nunavut data sets were unavailable. Data is based on the total number of beds divided by 2011
population statistics for each province.
Source: CMDB Hospital Beds Staffed and in Operations, Fiscal Year 2011-2012. Canadian Institute
for Health Information. Accessed at http://www.cihi.ca/CIHI-ext-portal/internet/EN/Quick_Stats/
quick+stats/quick_stats_main?xTopic=Spending&pageNumber=1&resultCount=10&lterTypeBy=un
dened&lterTopicBy=14&autorefresh=1 on September 1, 2013. www.cihi.ca. Source: Population by
year, by province and territory (Number). Stats Canada. Accessed at http://www.statcan.gc.ca/tables-
tableaux/sum-som/I01/cst01/demo02a-eng.htm, on September 1, 2013. www.statcan.gc.ca
Hospital beds
Canada, 2011-12
Hospital beds per 1,000 population
1.4
2.5
2.9
3.1
3.1
3.4
3.5
3.6
3.6
3.7
5
4.1
15 IHE IN YOUR POCKET 2014
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s
0 3 6 9 12 15
Japan
Germany
Austria
France
Finland^
Switzerland
Australia^
Italy
Norway
Spain
United States^
United Kingdom
New Zealand
Canada^
Sweden
Source: OECD Health Data: Health care resources: OECD Health Statistics (database).
Organization for Economic Co-operation and Development. Accessed at www.oecd-ilibrary.
org/social-issues-migration-health/hospital-beds, 20758480-table 5.1, on September 1, 2013;
http://www.oecd.org/statistics
Hospital beds
selected OECD countries, 2011
Hospital beds per 1,000 population
2.7
2.8
2.8
3
3.1
3.2
3.3
3.4
3.8
4.9
5.9
6.4
7.7
8.3
13.4
OECD Average: 4.9
16 INSTITUTE OF HEALTH ECONOMICS
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Source: Highlights of 2010-2011 inpatient hospitalizations and emergency department visits. Canadian
Institute for Health Information. Accessed at https://secure.cihi.ca/free_products/DADNACRS_
Highlights_2010-2011_En.pdf on September 1, 2013. www.cihi.ca
Acute inpatient
hospitalization rates
Canada, 2010-11
0 3000 6000 9000 12000 15000
Nunavut
Northwest Territories
Yukon
Saskatchewan
Prince Edward Island
New Brunswick
Newfoundland
Manitoba
Alberta
Nova Scotia
Canada
Quebec
British Columbia
Ontario
6,958
7,376
7,473
7,635
7,767
8,385
8,818
9,157
9,856
9,926
10,897
11,309
14,404
14,888
Hospitalization rate per 100,000 population
17 IHE IN YOUR POCKET 2014
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0 5000 10000 15000 20000 25000 30000
Austria
Germany
Finland
Norway*
Switzerland
France
Australia*
United Kingdom
Italy
United States*
Netherlands
Japan
Spain
Canada*
Note: * 2010 data.
Source: OECD Stat Extracts 2010. Organization for Economic Co-operation and Development.
Accessed at http://www.oecd-ilibrary.org.login.ezproxy.library.ualberta.ca/content/table/dischargerate-
diag-table-en on September 1, 2013. www.oecd.org.
Hospital discharge rates
selected OECD countries, 2010
8,249
10,417
11,055
12,201
12,549
12,945
13,640
15,945
16,853
16,965
17,526
18,007
24,417
27,347
Discharges per 100,000 population
OECD Average: 15,800
18 INSTITUTE OF HEALTH ECONOMICS
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Average length of inpatient
hospital stay
Canada, 2010-11
2.9
5.1
5.2
6.8
6.8
7.7
7.7
7.7
8.4
8.6
8.9
9
9
9.3
Number of days
Source: Inpatient Hospitalizations: Volumes, Length of Stay, and Standardized Rates. Canadian
Institute for Health Information. Accessed at http://apps.cihi.ca/MicroStrategy/asp/Main.aspx on
September 1, 2013. www.cihi.ca
Average length of inpatient hospital stay
7
8
2009-10 2008-09 2007-08 2006-07 2005-06 2004-05
0 2 4 6 8 10
Nova Scotia
Manitoba
New Brunswick
Prince Edward Island
Quebec
Newfoundland
Canada
British Columbia
Alberta
Saskatchewan
Ontario
Northwest Territories
Yukon
Nunavut
19 IHE IN YOUR POCKET 2014
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0 5 10 15 20
Japan
Germany
Canada
Finland
United Kingdom
Italy
Austria
Spain
New Zealand
United States
France
Australia
Number of days
Average length of stay for
acute care
selected countries, 2010
5
5.2
5.4
5.8
6.3
6.6
6.7
6.7
7
7.7
8.1
18.2
Source: OECD Stat Extracts, 2011. Organization for Economic Co-operation and Develop-
ment. Accessed at http://www.oecd-ilibrary.org/docserver/download/190800511e1t006.
pdf?expires=1378246684&id=id&accname=freeContent&checksum=515FF1BA60090DBF
1F89BE01BC74B9CA on September 1, 2013. www.oecd.org
OECD Average: 6.9
20 INSTITUTE OF HEALTH ECONOMICS
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s
e
r
v
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s
0 50 100 150 200
Ontario
Quebec
British Columbia
Alberta
Nova Scotia
Manitoba
Saskatchewan
New Brunswick
Nefoundland
and Labrador
Prince Edward Island
Yukon
Northwest Territories
Notes: MRI and CT machines in both hospitals and in free-standing facilities. No MRI data for Yukon
and Northwest Territories. No data for Nunavut. Source: Selected Medical Imaging Equipment in
Canada. Canada Institute for Health Information. Accessed at http://apps.cihi.ca/MicroStrategy/asp/
Main.aspx?server=torapprd30.cihi.ca&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=204800
1&visualizationMode=0&documentID=50A7B0D5472B6AE40A9AE7AA062D42EC on September
2, 2013.
CT and MRI scanners
Canada, 2012
0 (0)
0 (0)
1 (6.8)
5 (9.8)
6 (7.9)
6 (5.6)
8 (6.3)
9 (9.5)
39 (10.1)
40 (8.7)
90 (11.2)
104 (7.7)
1 (23.1)
1 (27.7
2 (13.7)
14 (27.3)
17 (22.5)
16 (14.8)
21 (16.6)
16 (16.9)
50 (12.9)
72 (15.6)
132 (16.4)
168 (12.4)
MRI CT
Number of devices (rate per 1,000,000 population)
21 IHE IN YOUR POCKET 2014
H
o
s
p
i
t
a
l

i
n
p
a
t
i
e
n
t

s
e
r
v
i
c
e
s
0 20 40 60 80 100 120
Japan
Australia
United States
Italy
Austria
OECD
Finland
Spain
New Zealand
Canada
France
United Kingdom
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT on September 2,
2013. www.oecd.org.
CT and MRI scanners
selected OECD countries, 2012
5.9
7.5
8.5
13.9
13.9
20.2
11.0
18.6
23.7
31.5
5.7
46.9
8.9
12.5
14.6
15.4
17.3
21.3
22.8
29.5
32.1
40.9
44.4
101.3
Devices rate per 1,000,000 population
MRI CT
22 INSTITUTE OF HEALTH ECONOMICS
Notes
Physician Services
24 INSTITUTE OF HEALTH ECONOMICS
P
h
y
s
i
c
i
a
n









s
e
r
v
i
c
e
s
Note: No data for specialists in Nunavut. Source: Health Indicators, 2013. Canadian Institute
for Health Information. Accessed at https://secure.cihi.ca/free_products/HI2013_EN.pdf on
September 3, 2013. www.cihi.ca
Number per 100,000 population
General and specialist
physician workforce
Canada, 2011
Source: Supply, Distribution, & Migration of Canadian physicians, 2011. Canadian
Institute for Health Information. Accessed at http://apps.cihi.ca/MicroStrategy/asp/Main.
aspx?server=torapprd30.cihi.ca&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048
001&visualizationMode=0&documentID=50A7B0D5472B6AE40A9AE7AA062D42EC on
September 16, 2013. www.cihi.ca
0 50 100 150 200
Yukon
Newfoundland
Nova Scotia
British Columbia
Quebec
New Brunswick
Alberta
Canada
Manitoba
Saskatchewan
Prince Edward Island
Ontario
Northwest Territories
Nunavut
General Physicians Specialist
80
80
99
23
0
100
97
95
65
33
93
103
106
100
117
95
119
108
32
105
106
111
113
114
117
122
123
Physician supply in Canada, 1978 - 2010
20000
30000
40000
2
0
1
0
2
0
0
8
2
0
0
6
2
0
0
4
2
0
0
2
2
0
0
0
1
9
9
8
1
9
9
6
1
9
9
4
1
9
9
2
1
9
9
0
1
9
8
8
1
9
8
6
1
9
8
4
1
9
8
2
1
9
8
0
1
9
7
8
Specialists
GP
25 IHE IN YOUR POCKET 2014
P
h
y
s
i
c
i
a
n








s
e
r
v
i
c
e
s
0 1 2 3 4 5
Germany
Italy
Spain
Norway^
Sweden^
Switzerland
Australia
France
United Kingdom
New Zealand
United States
Canada
Japan^
Note: ^ 2010 data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/Index.aspx?DatasetCode=HEALTH_STAT on September 3,
2013. www.oecd.org
Physician workforce
selected OECD countries, 2011
2.2
2.4
2.5
2.6
2.8
3.1
3.3
3.8
3.9
4.1
4.1
4.1
4.2
Professionally active physician per 1,000 population
OECD Average: 3.1
26 INSTITUTE OF HEALTH ECONOMICS
P
h
y
s
i
c
i
a
n









s
e
r
v
i
c
e
s
0 $100K $200K $300K $400K $500K
Alberta
Saskatchewan
New Brunswick
Nova Scotia
British Columbia
Canada
Newfoundland
Manitoba
Ontario
Prince Edward Island
Quebec
Average fee-for-service income
per full-time-equivalent physician
Canada, 2010-11
Source: National Physician Database, 2010-2011. Accessed at https://secure.cihi.ca/estore/
productSeries.htm?pc=PCC476 on September 3, 2013. www.cihi.ca
$217,633
$236,933
$235,893
$266,902
$244,938
$255,881
$283,247
$358,220
$268,049
$243,362
$280,761
$320,442
$325,480
$346,364
$346,706
$349,118
$356,263
$412,588
$456,557
$378,552
$381,707
$390,010
Family Medicine Specialist
CND$ per FTE physician
27 IHE IN YOUR POCKET 2014
P
h
y
s
i
c
i
a
n








s
e
r
v
i
c
e
s
0 50,000 100,000 150,000 200,000 250,000 300,000
Netherlands*
Canada*
Australia*
Austria^
Denmark
France*
$82,060
$135,571
$116,427
$83,775
$135,744
$143,131
$138,455
$179,692
$180,272
$206,854
$212,941
$253,920
Self-employed physician
income
selected OECD countries, 2011
Note: * 2010 data; ^ 2009 data; Australia, Canada were estimated data; Dollars are in US purchasing
power parity; Denmarks specialist data was from 2008.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development. Accessed at
http://stats.oecd.org/Index.aspx?DatasetCode=HEALTH_STAT on September 4, 2013. www.oecd.org
General Practitioner Specialist
US$ PPP
28 INSTITUTE OF HEALTH ECONOMICS
Notes
Other Health Care Providers
30 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
Dentist workforce
Canada, 2011
Source: Health Indicators, 2013. Canadian Institute for Health Information. Accessed at https://
secure.cihi.ca/free_products/HI2013_EN.pdf, on September 4, 2013. www.cihi.ca.
0 50 100 150 200
Nunavut
Yukon
Northwest Territories
British Columbia
Ontario
Canada
Quebec
Nova Scotia
Alberta
Manitoba
Prince Edward Island
New Brunswick
Saskatchewan
Newfoundland
35
38
42
50
50
54
57
59
60
64
67
125
126
195
Dentists per 100,000 population
31 IHE IN YOUR POCKET 2014
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0.0 0.3 0.6 0.9 1.2 1.5
Greece
Norway
Sweden^
Germany
Japan^
France
United States^
Canada
Italy
Australia
Netherlands^
New Zealand*
Notes: * 2009 data; ^ 2010 data; # 2007 data
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/index.aspx?queryid=30163# on September 4, 2013. www.
oecd.org.
Dentist workforce
selected OECD countries, 2011
0.45
0.50
0.57
0.58
0.60
0.61
0.64
0.78
0.84
0.85
0.99
1.28
Number of professionally active dentists per 1,000 population
OECD Average: 0.61
32 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0 300 600 900 1200 1500
Northwest Territories/
Nunavut
Newfoundland
Yukon
New Brunswick
Prince Edward Island
Nova Scotia
Manitoba
Saskatchewan
Quebec
Alberta
Canada
Ontario
British Columbia
Notes: Data for Northwest Territories and Nunavut were combined for 2011.
Source: Health Indicators, 2013. Accessed at https://secure.cihi.ca/free_products/HI2013_EN.pdf, on
September 4, 2013. www.cihi.ca
Source: Licensed Practical Nursing Workforce per 100,000 Population, Canada, 2007 to 2011.
Canadian Institute for Health Information. Accessed at http://www.cihi.ca/CIHI-ext-portal/internet/EN/
Quick_Stats/quick+stats/quick_stats_main?xTopic=Workforce&pageNumber=1&resultCount=10&lter
TypeBy=undened&lterTopicBy=16&autorefresh=1 on September 4, 2013. www.cihi.ca
Regulated nursing workforce
Canada, 2011
656
185
234
244
202
267
263
225
392
426
384
218
485
212
705
781
792
838
927
961
982
1,040
1,087
1,184
1,405
1,101
Licensed practical nursing workforce, Canada, 2007-2011
LPNs and RNs per 100,000 population
Regulated nurses per 100,000 population
0
500
1000
2010 2009 2008 2007 2006
LPNs RNs
LPNs
RNs
33 IHE IN YOUR POCKET 2014
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t
h
e
r

p
r
o
v
i
d
e
r
s
0 3 6 9 12 15
Norway
Sweden^
Switzerland
New Zealand
Iceland
Germany
Australia
Japan^
Canada
United Kingdom
Spain
Notes: ^ 2010 data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/Index.aspx?QueryId=30163 on September 4, 2013. www.
oecd.org.
Professional nurses practicing per 1,000 population
Professional nurse
workforce
selected OECD countries, 2011
5.5
6.9
6.9
7.2
8.4
8.7
8.7
9.4
10.7
11.1
12.9
OECD Average: 8.4
34 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
Source: Pharmacist Workforce by Count, Percentage and per 100,000 Population and Province or
Territory of Registration, 2006 to 2011. Canadian Institute for Health Information. Accessed at https://
secure.cihi.ca/free_products/HI2013_EN.pdf on September 4, 2013. www.cihi.ca
Source: Health Indicators, 2013. Canadian Institute for Health Information. Accessed at https://secure.
cihi.ca/free_products/HI2013_EN.pdf on September 4, 2013. www.cihi.ca
Pharmacist workforce
Canada, 2011
Canada, 2006-2011
2006 2007 2008 2009 2010 2011
100
90
80
0 30 60 90 120 150
Newfoundland
Nova Scotia
Prince Edward Island
Saskatchewan
Alberta
Manitoba
New Brunswick
Quebec
Canada
British Columbia
Nunavut
Yukon
Ontario
Northwest Territories
44
81
89
90
92
94
99
101
104
104
113
122
125
127
82.1
86.2
86.7
89.6
91.1
94
Per 100,000 population
Pharmacists per 100,000 population
35 IHE IN YOUR POCKET 2014
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0.0 0.2 0.4 0.6 0.8 1.0 1.2
Spain
France
Iceland
Italy*
Canada*
United States*
Israel
Sweden^
Norway*
New Zealand
Germany*
Hungary
Note: * 2011 data
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development. Accessed at
http://stats.oecd.org/Index.aspx?QueryId=30163 on September 4, 2013. www.oecd.org.
Professionally active
pharmacists
selected OECD countries, 2012
0.72
OECD Average: 0.76
0.73
0.75
0.8
0.81
0.84
0.87
0.91
0.95
1.12
1.13
1.2
Professionally active pharmacists per 1,000 population
36 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
Note: No information for Northwest Territories and Nunavut.
Source: Health Indicators, 2013. Canadian Institute for Health Information. Accessed at https://secure.cihi.
ca/free_products/HI2013_EN.pdf on September 4, 2013. www.cihi.ca
Physiotherapist workforce
Canada, 2011
0 20 40 60 80 100
Yukon
British Columbia
New Brunswick
Nova Scotia
Manitoba
Saskatchewan
Alberta
Canada
Quebec
Ontario
Newfoundland
Prince Edward Island
42
43
46
48
51
56
57
58
60
60
62
97
Per 100,000 population
37 IHE IN YOUR POCKET 2014
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0.0 0.5 1.0 1.5 2.0
Finland^
Netherlands^
Norway*
Iceland
Germany*
Sweden^
France
New Zealand*
Italy*
Australia
United States*
Canada*
United Kingdom
Notes: * 2011 data, ^ 2010 data, United Kingdom is estimated data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/Index.aspx?QueryId=30163 on September 4, 2013. www.
oecd.org
Practicing physiotherapists
selected OECD countries, 2012
0.44
0.51
0.6
0.64
0.83
0.95
1.19
1.26
1.43
1.56
1.61
1.82
1.95
Practicing physiotherapists per 1,000 population
38 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
Notes: No registered midwife numbers for Newfoundland and Labrador; only nurse-midwives in hospitals
which have been excluded. No report was available for Nunavut numbers. Ontario has over 600 but no
exact number has been given. Quebec numbers are for those who are part of the association (RSFQ).
Source: Midwifery in Canada. Canadian Midwives. Accessed at http://www.canadianmidwives.org/
province/Alberta.html on September 4, 2013. http://www.canadianmidwives.org on September 4, 2013.
Midwifery workforce
Canada, 2012
0 200 400 600 800 1000 1200
Canada
Ontario
British Columbia
Quebec
Alberta
Manitoba
Saskatchewan
Nova Scotia
Northwest Territories
Yukon
Prince Edward Island
New Brunswick
0
0
1
2
6
12
42
73
131
200
600
1,067
Number of midwives
39 IHE IN YOUR POCKET 2014
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8
Sweden^
Finland
New Zealand
Norway*
Italy*
Japan^
Germany*
Netherlands^
France
Canada*
Notes: * 2011 data, ^ 2010 data
Source: Organization for Economic Co-operation and Development Stat Extracts. Accessed at http://stats.
oecd.org/Index.aspx?QueryId=30163 on September 4, 2013. www.oecd.org
Professionally active midwives
selected OECD countries, 2012
0.03
0.31
0.19
0.23
0.23
0.25
0.6
0.64
0.69
0.77
Density per 1,000 population
40 INSTITUTE OF HEALTH ECONOMICS
O
t
h
e
r

p
r
o
v
i
d
e
r
s
Note: No information for Northwest Territories and Nunavut.
Source: Health Indicators, 2013. Canadian Institute for Health Information. Accessed at https://secure.
cihi.ca/free_products/HI2013_EN.pdf on September 4, 2013. www.cihi.ca
Chiropractor workforce
Canada, 2011
0 5 10 15 20 25 30 35
Ontario
Canada
Alberta
British Columbia
Yukon
Manitoba
Saskatchewan
Quebec
Nova Scotia
Newfoundland
New Brunswick
Prince Edward Island
5
8
12
13
16
18
21
23
24
24
24
32
Chiropractors per 100,000 population
41 IHE IN YOUR POCKET 2014
O
t
h
e
r

p
r
o
v
i
d
e
r
s
0 5 10 15 20 25
Australia
United States
Canada
Norway
New Zealand
Sweden
United Kingdom
Switzerland
Netherlands
Finland
France
Italy
Spain
Japan
Germany
Chiropractor workforce
selected OECD countries, 2012
Source: World Stats - Chiropractic statistics. Chiropractic Diplomatic Corp. Accessed at http://
www.chiropracticdiplomatic.com on September 4, 2013.
0.1
0.6
0.7
0.7
0.7
1.0
2.4
3.5
3.5
4.2
9.1
12.1
18.8
19.7
21.5
Chiropractors per 100,000 population
42 INSTITUTE OF HEALTH ECONOMICS
Notes
Continuing Care and Home Care
44 INSTITUTE OF HEALTH ECONOMICS
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Source: Table 3-1, Movement of residents during scal year in operating residential care facilities
characteristics and geography Canada. Stats Canada. Accessed at http://www.statcan.gc.ca/
pub/83-237-x/2012001/t004-eng.htm on September 8, 2013. www.statcan.gc.ca
Residents in long-term
operating facilities
Canada, 2009-2010
On books April 1 Admission
All residential care facilities 246,133 546,168
Homes for the aged number (rate per
1,000 population 65 years or older)
202,761 (43.3) 114,695 (24.5)
Facilities for persons with mental
disorders
35,285 151,232
Other residential care facilities 8,087 280,241
Number of residents
45 IHE IN YOUR POCKET 2014
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Source: Table 7-1. Total expenditures in operating residential care facilities by facility characteristics
and geography Canada. Stats Canada. Accessed at http://www.statcan.gc.ca/pub/83-
237-x/2012001/t008-eng.htm on September 8, 2013. www.statcan.gc.ca
Number, beds and total
expenditures in
residential care facilities
Canada, 2009-10
Operating facilities Reporting facilities Total
expenditures
(millions of
dollars)
number approved
beds
number approved
beds
Total residential
care facilities
4,633 265,220 3,355 211,243 $17,012.2
Total homes for
the aged
2,136 215,313 1,565 173,631 $13,665.8
Total facilities
for persons with
mental disorders
2,202 40,258 1,570 29,884 $2,838.5
Total other
residential care
facilities
295 9,649 220 7,728 $508.0
46 INSTITUTE OF HEALTH ECONOMICS
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Source: Table 2-1. Resident-days in operating residential care facilities by responsibility for payment,
facility characteristics and geography Canada. Stats Canada. Accessed at http://www.statcan.gc.ca/
pub/83-237-x/2012001/t002-eng.htm, on September 8, 2013. www.statcan.gc.ca
Residentdays by responsibility
for payment in long-term
operating facilities
Canada, 2009-2010
All sources Provincial
health
insurance
plan
Provincial
social
assistance
plan
Other
provincial
department
Municipality
or district
All other
sources,
including
self-pay
All
residential
care
facilities
90,330,142
(100%)
67,245,643
(74.4%)
11,254,817
(12.5%)
405,260
(0.4%)
1,425,853
(1.6%)
9,998,569
(11.1%)
Homes for
the aged
74,442,220
(100%)
61,716,151
(82.9%)
3,429,132
(4.6%)
173,494
(0.2%)
684,697
(0.9%)
8,438,746
(11.3%)
Facilities
for persons
with mental
disorders
12,967,568
(100%)
4,400,392
(33.9%)
7,015,313
(54.1%)
199,312
(1.5%)
228,217
(1.8%)
1,124,334
(8.7%)
Other
residential
care
facilities
2,920,354
(100%)
1,129,100
(38.7%)
810,372
(27.7%)
32,454
(1.1%)
512,939
(17.6%)
435,489
(14.9%)
47 IHE IN YOUR POCKET 2014
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Source: OECD Health System Accounts, 2010. Organization for Economic Co-operation and
Development. Accessed at http://www.oecd.org/els/health-systems/47884942.pdf on September 27,
2013.
Longterm care expenditures
by sources of funding
selected OECD countries, 2007
Countries ranked by decreasing share of
out-of-pocket spending
0 20 40 60 80 100
Netherlands
France
Sweden
New Zealand
Japan
Australia
Norway
Finland
Canada
Austria
Spain
Germany
Switzerland
Government revenue Social security
Other
Private insurance
Out-of-pocket
48 INSTITUTE OF HEALTH ECONOMICS
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Source: Figure 1, Percentage of seniors receiving home care, by type and source, household
population aged 65 or older, Canada, 2009. Stats Canada.
Accessed at http://www.statcan.gc.ca/pub/82-003-x/2012004/article/11760/c-g/g1-eng.htm on
September 8, 2013. www.statcan.gc.ca
Percentage of older adults
receiving home care, by type
of service and source
Canada, 2009
0 3 6 9 12 15
Housework
Medical
Personal
Meal Preparation
Transportation
Managing
0
0
6
1
1
13
1
1
8
1
2
4
1
3
3
2
5
11
Mixed Formal Informal
Percentage of population 65 and older
49 IHE IN YOUR POCKET 2014
C
o
n
t
i
n
u
i
n
g

c
a
r
e

a
n
d

h
o
m
e

c
a
r
e
Users of longterm care
services across the OECD
selected OECD countries, 2007
Source: OECD Health Data, 2010. Organization for Economic Co-operation and Development.
Accessed at http://www.oecd.org/els/health-systems/47884942.pdf on September 27, 2013.
Institution Home
0.00 0.05 0.10 0.15 0.20 0.25
Austria
Netherlands
Switzerland
Norway
Sweden
New Zealand
Japan
Finland
Australia
Germany
Canada
Italy
Spain
50 INSTITUTE OF HEALTH ECONOMICS
Source: Table 12-1 Income per resident-day in operating residential care facilities by facility
characteristics and geography Canada. Stats Canada. Accessed at http://www.statcan.gc.ca/
pub/83-237-x/2012001/t013-eng.htm on September 8, 2013. www.statcan.gc.ca
Facility income per
resident-day
Canada, 2009-2010
CND$ per resident-day
$175.7
$185.0
$189.6
$219.4
0 50 100 150 200 250
Facilities for persons
with mental disorders
Residential care
facilities
Homes for the aged
Other residential
care facilities
Pharmaceuticals
52 INSTITUTE OF HEALTH ECONOMICS
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0 200 400 600 800 1000 1200
Nova Scotia
New Brunswick
Newfoundland
Quebec
Ontario
Prince Edward Island
Saskatchewan
Manitoba
Alberta
Yukon
British Columbia
Northwest Territories
Nunavut
Note: 2012 data is forecast.
Source: Drug Expenditure in Canada, 1985 to 2012. Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1952 on
September 9, 2013. www.cihi.ca
Pharmaceutical expenditures
per capita
Canada, 2012
$657.2 (45.6%)
$701.6 (50%)
$735.7 (31.65%)
$743.8 (46.6%)
$872.9 (40.4%)
$874.2 (35.6%)
$896.4 (41.6%)
$940 (28.9%)
$955.4 (37.1%)
$1,063.1 (40.6%)
$1,088.6 (30.8%)
$1,110.2 (32.5%)
$1,160.2 (32.5%)
Public Private
Expenditures per capita (percent from public sector)
53 IHE IN YOUR POCKET 2014
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0 200 400 600 800 1000
United States
Canada
Japan*
France
Germany
Australia*
Spain
Switzerland
Italy
Netherlands
Sweden
Finland
Norway
United Kingdom^
OECD Average: $487.0
Notes: *2010 data, #2009 data, ^2008 data; amount shown in US purchasing power parity.
Source: Health at a Glance, 2011, OECD Indicators. Organization for Economic Co-operation
and Development. Accessed at http://www.oecd-ilibrary.org/social-issues-migration-health/
pharmaceutical-expenditure-per-capita_pharmexpcap-table-en on September 9, 2013. www.
oecd.org
Pharmaceutical and other
medical non-durables
expenditures
selected OECD countries, 2011
$375.0
$387.7
$446.2
$474.0
$479.3
$487.3
$530.7
$535.8
$587.0
$632.6
$641.1
$652.0
$751.5
$995.0
US$ PPP per capita
54 INSTITUTE OF HEALTH ECONOMICS
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0.0 0.5 1.0 1.5 2.0 2.5
United States
Germany
Canada
United Kingdom
Italy
Sweden
France
Switzerland
Note: Amount shown in US$ purchasing power parity.
Source: Annual report, 2011. Patented Medicine Prices Review Board. Accessed at http://www.
pmprb-cepmb.gc.ca/CMFiles/Publications/Annual%20Reports/2011/2011-Annual-Report_EN_
Final-for-Posting.pdf on September 9, 2013. http://www.pmprb-cepmb.gc.ca
Average foreign-to-Canadian
price ratios for patented drugs
selected OECD countries, 2011
0.81
0.81
0.88
0.89
0.91
1
1.27
2.28
55 IHE IN YOUR POCKET 2014
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0.0 0.3 0.6 0.9 1.2 1.5
Switzerland
Canada
France
Italy
Germany
United States
United Kingdom
Sweden
Note: Bilateral comparators. Amount shown in retail price.
Source: Generic drugs in Canada: International price comparisons and potential cost savings.
Patented Medicine Prices Review Board. Accessed at http://www.pmprb-cepmb.gc.ca/english/
view.asp?x=1562&all=true#1439 on September 9, 2013. www.pmprb-cempmb.gc.ca
Average foreign-to-Canadian
price ratios for generic drugs
selected OECD countries, 2008
0.37
0.53
0.57
0.69
0.78
0.82
1
1.26
56 INSTITUTE OF HEALTH ECONOMICS
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
Source: Table 2, Provincial statistics and their relationship to gross domestic expenditures on
research and development, 2010. Stats Canada. Accessed at http://www.statcan.gc.ca/pub/88-
221-x/2012001/t063-eng.htm on September 9, 2013. www.statcan.gc.ca
Pharmaceutical research
and development spending
per capita
Canada, 2011
CDN$ per capita
0 10 20 30 40 50 60
Quebec
Ontario
Canada
Alberta
Nova Scotia
British Columbia
Newfoundland
Manitoba
Saskatchewan
New Brunswick
Prince Edward Island
Territories
0.6
0.8
2.7
2.7
8.8
9.5
9.9
11.9
18.0
28.5
31.4
52.1
57 IHE IN YOUR POCKET 2014
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0 30 60 90 120 150
Switzerland
United Kingdom
Sweden
Germany
United States
France
Canada
Italy
Note: Companies without sales of patented medicines need not report to the Patented
Medicine Prices Review Board on their R & D expenditures. The statistical results reported
should not be taken to cover all pharmaceutical research conducted.
Source: Annual Report 2011, Analysis of Research & Development Expenditures. Patented
Medicine Prices Review Board. Accessed at http://www.pmprb-cepmb.gc.ca/english/view.
asp?x=1625&mid=1552 on September 27, 2013. www.pmprb-cepmb.gc.ca.
Pharmaceutical Patentees,
R & Dto-sales ratios
selected OECD countries, 2009
6.6%
7.5%
18.3%
19.5%
19.9%
26.9%
39.8%
133.5%
58 INSTITUTE OF HEALTH ECONOMICS
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
46.1%
38.4%
15.7%
Note: Public sector (38.4%) only nance prescribed drugs, while private sector (61.8%)
nance prescribed drugs, as well as over-the-counter drugs and personal health supplies.
Source: Drug Expenditure in Canada, 1985 to 2012. Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/free_products/DEIC_1985_2011_EN.pdf on September
9, 2013. www.cihi.ca
Percentage share of
expenditure on drugs by
source of nance
Canada, 2010
Private sector - presecribed drugs
Public sector - prescribed drugs
Private sector - non-prescribed drugs
59 IHE IN YOUR POCKET 2014
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0 10 20 30 40 50 60 70 80
Manitoba
New Brunswick
Saskatchewan
British Columbia
Prince Edward Island
and Newfoundland
Nova Scotia
Alberta
Ontario
Canada
Quebec 61.8%
63.2%
63.6%
64.0%
64.2%
64.6%
64.7%
65.7%
66.0%
68.5%
Source: The Canadian generic market year 2012. Canadian Generic Pharmaceutical
Association. Accessed at http://www.canadiangenerics.ca/en/resources/market_trends.asp on
September 9, 2013. www.canadiangenerics.ca
Generic share of the
prescription drug market
Canada, 2012
Percentage share of the generic drugs
60 INSTITUTE OF HEALTH ECONOMICS
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
0 100 200 300 400 500 600
Prince Edward
Island^
Nova Scotia
Quebec
Manitoba
Ontario
Saskatchewan
Newfoundland
Non-insured
health benefits*
Alberta
British Columbia
New Brunswick 192
Note: *2010 data; ^2009 data.
Source: How good is your drug insurance? Comparing federal, provincial and private-sector
plans, 2004 2011. Canadian Health Policy. Accessed at http://www.canadianhealthpolicy.
com/downloads/research-pdfs/how-good-is-your-drug-insurance-2013-revised.pdf on
September 10, 2013. www.canadianhealthpolicy.com
Wait time for public
insurance approval of
new pharmaceuticals
Canada, 2011
213
236
267
284
297
298
299
304
329
540
Number of days
Average wait days for public insurance approval
of new drugs, Canada, 2004 - 2011
200
400
600
800
1000
2011 2010 2009 2008 2007 2006 2005 2004
61 IHE IN YOUR POCKET 2014
P
h
a
r
m
a
c
e
u
t
i
c
a
l
s
Source: Wyatt Health Management. Accessed at http://www.wyatthealth.com/ on October 11, 2013.
International Positive
Reimbursement
All eligible drugs based on the
Canadian list, 2011-2012
Median approval times for new drugs (in days)
200
400
600
800
1000
After 2007 2002 - 2006 1997 - 2001 Before 1996
Drugs approved in both Canada and U.S.
Drugs approved in Canada
0
20
40
60
80
100
U
n
i
t
e
d

S
t
a
t
e
s
G
e
r
m
a
n
y
I
t
a
l
y
F
r
a
n
c
e
S
w
i
t
z
e
r
l
a
n
d
A
u
s
t
r
a
l
i
a
S
w
e
d
e
n
U
n
i
t
e
d

K
i
n
g
d
o
m
A
v
e
r
a
g
e
N
e
t
h
e
r
l
a
n
d
s
F
i
n
l
a
n
d
J
a
p
a
n
A
u
s
t
r
i
a
C
a
n
a
d
a
N
o
r
w
a
y
N
e
w

Z
e
a
l
a
n
d
Restricted Unrestricted
62 INSTITUTE OF HEALTH ECONOMICS INSTITUTE OF HEALTH ECONOMICS
Notes
Public Health
64 INSTITUTE OF HEALTH ECONOMICS
P
u
b
l
i
c

H
e
a
l
t
h
Source: National Health Expenditure Trends, 1975 to 2012, Canadian Institute for Health Information.
Accessed at https://secure.cihi.ca/free_products/NHEXTrendsReport2012EN.pdf, Table D1 on
September 29, 2013. www.cihi.ca.
Expenditure on public health
as percentage of total health
expenditure
Canada, 2010
0 5 10 15 20
Yukon
Nunavut
Northwest Territories
Saskatchewan
Manitoba
British Columbia
Ontario
Alberta
Canada
Quebec
Prince Edward Island
New Brunswick
Newfoundland
Nova Scotia
3.1
3.2
3.3
4.4
4.9
5.4
5.8
6.0
6.7
7.0
8.4
9.1
11.3
17.6
Percentage
65 IHE IN YOUR POCKET 2014
P
u
b
l
i
c

H
e
a
l
t
h
0 1 2 3 4 5 6 7 8
New Zealand
Canada
Finland
Netherlands
Sweden
United States
Germany
Japan
Norway
Switzerland
Spain
France
Australia
Italy
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development. Accessed at
http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT on September 29, 2013. www.oecd.org.
Expenditure on prevention and
public health as percentage of
total health expenditure
selected OECD countries, 2010
0.4
1.7
2
2.3
2.4
2.5
3
3.3
3.3
3.5
3.1
5.2
5.9
7
Percentage of total health expenditure
66 INSTITUTE OF HEALTH ECONOMICS
P
u
b
l
i
c

H
e
a
l
t
h
Source: Everybodys Business: The cost of multi-department involvement in public health in
Alberta. Institute of Health Economics. Access at http://www.ihe.ca/publications/library/2011/
everybodys-business-the-cost-of-multi-department-involvement-in-public-health-in-alberta/ on
September 29, 2013. www.ihe.ca.
Per capita costs of public
health functions
Canada, 2009
Federal Provincial
Health
Ministry
Non-Health
Ministries
Health
Ministries
Non-Health
Ministries
Alcohol General $1.64 $0.48
Alcohol FASD $0.64 $0.85
Consumer Product
Safety
$0.71
Environment Health $3.87 $53.21 $7.69 $117.12
Food Safety $18.60 $2.25 $7.22 $5.80
Infectious Disease
Prevention
$0.57 $18.33
Maternal & Infant Health $2.74 $25.33
Occupational Health
& Safety
$0.17
Physical Activity &
Nutrition
$0.61 $4.50 $15.50
Road Safety $1.08 $24.70
Tobacco $1.99 $0.51 $2.52
Subtotal $29.16 $62.12 $37.57 $189.78
Capital
Built Environment $0.33
Housing &
Homelessness
$74.85 $143.97
Physical Activity (Parks) $8.33 $28.77
Subtotal $0.00 $83.51 $0.00 $172.74
67 IHE IN YOUR POCKET 2014
P
u
b
l
i
c

H
e
a
l
t
h
0 20 40 60 80 100
Pol3
MCV
DTP1
PCV3
Hib3
DTP3
HepB3
Notes:
DTP1: First dose of diphtheria toxoid, tetanus toxoid and pertussis vaccine
DTP3: Third dose of diphtheria toxoid, tetanus toxoid and pertussis vaccine
HepB3: Third dose of hepatitis B vaccine
Hib3: Third dose of Haemophilus inuenzae type B vaccine
MCV: Measles-containing vaccine
PCV3: Pneumococcal Conjugate 3rd dose
Pol3: Third dose of Polio
Source: WHO vaccine-preventable diseases: monitoring system. 2013 Global summary. World
Health Organization. Accessed at http://apps.who.int/immunization_monitoring/globalsummary/
estimates?c=CAN on September 10, 2013. http://www.who.int/en/
National immunization
coverage select vaccines
Canada, 2012
70%
95%
95%
97%
98%
98%
99%
Percent coverage
68 INSTITUTE OF HEALTH ECONOMICS
P
u
b
l
i
c

H
e
a
l
t
h
0 20 40 60 80 100
Germany
France
Spain
Italy
New Zealand
Canada
United States
Australia
Austria
Note: DTP stands for diphtheria, tetanus, and pertussis.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development. Accessed
at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT on September 10, 2013. www.
oecd.org
Childhood vaccine coverage
selected OECD countries, 2012
83%
92%
91%
70%
95%
96%
97%
65%
93%
83%
92%
94%
95%
95%
96%
97%
99%
99%
76%
94%
91%
98%
93%
90%
95%
89%
99%
Percentage of children immunized
Hepatitis B DTP Measles
69 IHE IN YOUR POCKET 2014
P
u
b
l
i
c

H
e
a
l
t
h
0 20 40 60 80 100
United States
New Zealand#
Germany^
Italy
Canada*
Switzerland#
France
Greece^
Poland^
Spain^
Belgium*
Netherlands
Hungary^
Japan
Notes: *2008 data; ^2009 data; #2007 data.
Source: OECD stat extracts; 2011. Organization for Economic Co-operation and
Development. Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
on September 10, 2013. www.oecd.org
Percentage of women aged
20-69 receiving Pap Smear
screening
selected OECD countries, 2010
37.7%
63.5%
65.7%
67.4%
68.5%
69.1%
69.7%
71.1%
74.9%
75.3%
76.9%
78.7%
79.6%
85%
Percentage of female population aged 20 to 69
OECD Average: 61%^
70 INSTITUTE OF HEALTH ECONOMICS
P
u
b
l
i
c

H
e
a
l
t
h
Notes: *2008 data; ^2009 data; #2007 data.
Source: OECD stat extracts; 2011. Organization for Economic Co-operation and
Development. Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
on September 10, 2013. www.oecd.org
Percentage of women aged
50-69 having a mammogram
selected countries, 2010
Percentage of female population aged 50 to 69
0 20 40 60 80 100
Netherlands
United States
New Zealand#
France
Spain^
Belgium*
Canada*
Italy
Germany^
Hungary^
Switzerland#
Japan
36%
45%
65%
68%
70%
73%
73%
73%
75%
77%
80%
88%
OECD Average: 62.2%
Health Behaviors
72 INSTITUTE OF HEALTH ECONOMICS
H
e
a
l
t
h


b
e
a
h
v
i
o
r
s
0 10 20 30 40 50 60
Nunavut
Northwest Territories
Yukon
Saskatchewan
Nova Scotia
Alberta
New Brunswick
Quebec
Prince Edward Island
Newfoundland
and Labrador
Manitoba
Canada
Ontario
British Columbia
Percentage of population
12 and over who are current
smokers
Canada, 2011
Source: Smokers, by sex, provinces and territories (Percent). Statistics Canada. Accessed
at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health74b-eng.htm on
September 10, 2013. http://www.statcan.gc.ca
Percentage of population aged 12 and over
15.8
19.4
19.9
20
20.4
21
21
21.7
21.7
21.8
23.8
29.3
34.9
59.7
73 IHE IN YOUR POCKET 2014
H
e
a
l
t
h

b
e
h
a
v
i
o
r
s
0 5 10 15 20 25 30
Spain*
France
Germany*
United Kingdom*
Netherlands
Switzerland^
Japan
Norway#
Finland
New Zealand^
Canada
United States
Australia
Sweden
Percentage of population
who are daily smokers
selected OECD countries, 2010
Percentage of population aged 15 and above
Notes: *2009 data, ^2007 data.
Source: OECD stat extracts; 2011. Organization for Economic Co-operation and
Development. Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
on September 10, 2013. www.oecd.org
13.6
15.1
15.1
16.3
18.1
19
19
19.5
20.4
20.9
21.5
21.9
23.3
26.2
OECD Average: 21.13
74 INSTITUTE OF HEALTH ECONOMICS
H
e
a
l
t
h


b
e
a
h
v
i
o
r
s
Note: Population aged 12 and over who reported having 5 or more drinks on one occasion, at
least once a month in the past 12 months; * use with caution.
Source: Heavy drinking, by sex, provinces and territories. Statistics Canada. (Percent).
Accessed at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health80b-eng.htm
on September 10, 2013. http://www.statcan.gc.ca
Alcohol consumption for
persons 12 and above
Canada, 2011
Percentage of population drinking heavily aged 12 and over
16.6
18.3
18.5
19
19.5
20.3
21.3
21.7
21.7
22.9
24.6
26.1
26.4
31.2
0 5 10 15 20 25 30 35
Northwest Territories
Newfoundland
and Labrador
Nunavut*
Yukon
Manitoba
Saskatchewan
New Brunswick
Alberta
Nova Scotia
Prince Edward Island
Canada
Quebec
Ontario
British Columbia
75 IHE IN YOUR POCKET 2014
H
e
a
l
t
h

b
e
h
a
v
i
o
r
s
0 2 4 6 8 10 12
France*
Germany^
Spain^
Australia^
United Kingdom
Switzerland
Finland
New Zealand
Netherlands^
United States
Canada
Sweden
Japan
Italy^
Norway
Note: ^2009 data.
Source: OECD stat extracts, 2011. Organization for Economic Co-operation and
Development. Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#
on September 10, 2013. www.oecd.org.
Liters consumed per person, per year
Alcohol consumption for
persons 15 and above
selected OECD countries, 2011
6.6
6.9
7.3
7.3
8.2
8.6
9.4
9.6
9.7
10
10.2
10.3
11.4
11.7
12
OECD Average: 9.1
76 INSTITUTE OF HEALTH ECONOMICS
H
e
a
l
t
h


b
e
a
h
v
i
o
r
s
Overweight or obese adult
population
Canada, 2011
Note: Measured for those 18 years and over only.
Source: Body mass index, overweight or obese, self-reported, adult, by sex, provinces and
territories (Percent). Statistics Canada. Accessed at http://www.statcan.gc.ca/tables-tableaux/
sum-som/l01/cst01/health82b-eng.htm on September 10, 2013. http://www.statcan.gc.ca
0 10 20 30 40 50 60 70 80
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Saskatchewan
New Brunswick
Manitoba
Nunavut
Prince Edward Island
Yukon
Ontario
Alberta
Canada
Quebec
British Columbia
46.6
50.1
52.1
52.2
52.3
55
57.6
58.2
58.4
59.4
59.4
60.7
61
69.3
Percentage of population
81 IHE IN YOUR POCKET 2014
H
e
a
l
t
h

s
t
a
t
u
s
0 1 2 3 4 5 6 7 8
United States#
New Zealand^
Canada*
United Kingdom
Australia
Netherlands
Switzerland
Germany
Italy
Spain
Norway
Sweden
Finland
Japan
Mortality rate per 1,000 live births
Note: ^2009 data.
Source: OECD Stat Extracts, 2011. Organization for Economic Co-operation and
Development. Accessed at http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_STAT on
September 11, 2013. www.oecd.org
Infant mortality
selected OECD countries, 2010
2.3
2.3
2.5
2.8
3.2
3.4
3.4
3.8
3.8
4.1
4.2
4.9
5.5
6.2
OECD Average: 4.3
82 INSTITUTE OF HEALTH ECONOMICS
Notes
Demographics
84 INSTITUTE OF HEALTH ECONOMICS
D
e
m
o
g
r
a
p
h
i
c
s
4000
6000
8000
10000
12000
2036 2031 2026 2021 2016 2011
Source: Population by sex and age group, by province and territory (proportion of, both sexes).
Statistics Canada. Accessed at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/
demo31d-eng.htm on September 11, 2013. http://www.statcan.gc.ca
Population aged 65 and above
Canada, 2012
Notes: Numbers in thousands; based on medium growth.
Source: Projected population by age groups and sex according to three projection scenarios for 2010,
2011, 2016, 2021, 2026, 2031 and 2036. Statistics Canada. Accessed at http://www.statcan.gc.ca/
tables-tableaux/sum-som/l01/cst01/demo23g-eng.htm on September 11, 2013. www.statcan.gc.ca.
Projected population aged 65 and above in Canada,
2016 2036
0 5 10 15 20
Nova Scotia
New Brunswick
Newfoundland and Labrador
Prince Edward Island
Quebec
British Columbia
Canada
Saskatchewan
Ontario
Manitoba
Alberta
Yukon
Northwest Territories
Nunavut
Percent of population
3.3
6.2
9.4
11.1
14.2
14.6
14.7
14.9
15.9
16.2
16.4
16.6
17
17.2
5,956.5
4,974.3
7,091.4
8,383.5
9,610.6
10,379.8
85 IHE IN YOUR POCKET 2014
D
e
m
o
g
r
a
p
h
i
c
s
0 5 10 15 20 25
Japan
Italy
Germany
Sweden
Spain
France
Switzerland
United Kingdom
Netherlands
Norway
Canada
Australia
New Zealand
United States
Percent of population
Note: *2010 data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT# on September
10, 2013. www.oecd.org
Population aged 65 and above
selected OECD countries, 2013
13.2
13.3
13.7
14.7
15.2
15.9
16.2
17.1
17.1
17.6
19.3
20.7
21
23.3
OECD Average: 14.8
86 INSTITUTE OF HEALTH ECONOMICS
D
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m
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g
r
a
p
h
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s
Life expectancy at birth
Canada, 1920-2002
Source: Life expectancy at birth, by sex, by province. Statistics Canada. Accessed at http://www.
statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health26-eng.htm on September 11, 2013. www.
statcan.gc.ca.
40
60
80
100
Years
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63
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72
75
77
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87 IHE IN YOUR POCKET 2014
D
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76 77 78 79 80 81 82 83 84
Japan
Switzerland
Italy
Spain
Australia
France
Sweden
Norway
New Zealand
Netherlands
Canada*
United Kingdom
Germany
United States
Years
Note: *2009 data.
Source: Factbook Country Statistical Proles 2013 edition MetaData: Health. Organization
for Economic Co-operation and Development. Accessed at http://stats.oecd.org/Index.
aspx?DatasetCode=CSP2012# on September 11, 2013. www.oecd.org.
Life expectancy at birth
selected OECD countries, 2010
78.7
80.5
80.7
81
81
81
81.2
81.6
81.8
81.8
82.2
82.4
82.6
82.9
OECD Average: 79.5
88 INSTITUTE OF HEALTH ECONOMICS
D
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o
g
r
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s
0.0 0.5 1.0 1.5 2.0 2.5 3.0
Nunavut
Saskatchewan
Northwest Territories
Manitoba
Alberta
Yukon
Quebec
Prince Edward Island
Canada
New Brunswick
Ontario
Nova Scotia
Newfoundland and Labrador
British Columbia
Fertility rates
Canada, 2011
Note: Fertility rate is the average number of children per women.
Source: Births and total fertility rate, by province and territory (fertility rate). Statistics Canada.
Accessed at http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/hlth85b-eng.htm on
September 11, 2013. www.statcan.gc.ca
1.4
1.5
1.5
1.5
1.5
1.6
1.6
1.7
1.7
1.8
1.9
2
2
3
Average number of children per woman
89 IHE IN YOUR POCKET 2014
D
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France
United Kingdom
Sweden
Norway
United States
Australia
Finland
Netherlands
Canada*
Switzerland
Italy
Japan
Germany
Spain
Note: *2009 data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT# on September
10, 2013. www.oecd.org
Fertility rates
selected OECD countries, 2011
1.4
1.4
1.4
1.4
1.5
1.6
1.8
1.8
1.9
1.9
1.9
1.9
2
2
Average number of children per woman
OECD Average*: 1.71
90 INSTITUTE OF HEALTH ECONOMICS
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92 INSTITUTE OF HEALTH ECONOMICS
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index
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Note: A higher score refers to more favorable performance.
Source: Canada Health Consumer Index, 2011. Frontier Centre for Public Policy. Policy Series No.
124, Dec 2011. Accessed at http://www.fcpp.org/publication.php/4018 on September 12, 2013.
http://www.fcpp.org
Scores in each element
0 200 400 600 800 1000
Ontario
British Columbia
New Brunswick
Manitoba
Alberta
Newfoundland/Labrador
Prince Edward Island
Quebec
Saskatchewan
Nova Scotia
Outcomes
Range and reach of services and access to new medicines
Wait times
Primary care and
problem prevention
Patient access to information
93 IHE IN YOUR POCKET 2014
H
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Scores (Overall country rankings)
Source: Euro-Canada Health Consumer Index, 2010. Frontier Centre for Public Policy.
Policy Series No. 89, May 2010. Accessed at http://www.fcpp.org/publication.php/3285 on
September 12, 2013. http://www.fcpp.org
Euro-Canada health consumer
pentathalon
selected OECD countries, 2010
0 200 400 600 800 1000
Netherlands
Germany
France
Switzerland
Austria
Sweden
Norway
Italy
UK
Greece
Spain
Canada 594 (25)
639 (20)
640 (19)
666 (17)
694 (14)
741 (11)
768 (9)
804 (6)
806 (5)
809 (4)
825 (2)
857 (1)
Range and reach of services
and access to new medicines
Medicines
Outcomes
Wait times Patient access to information
94 INSTITUTE OF HEALTH ECONOMICS
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Canadian provincial healthcare
index
Canada, 2013
Note: Provision of healthcare is captured using 46 indicators, and aggregated into four broad
components. A MinMax method is then used to give each province a score from 0 to 10 for overall
value.
Source: Provincial healthcare index, 2013. Fraser Institute. Accessed at http://www.fraserinstitute.
org/uploadedFiles/fraser-ca/Content/research-news/research/publications/provincial-healthcare-
index-2013.pdf on September 12, 2013. www.fraserinstitute.org
Component Result
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Alberta 3.06 7.88 7.75 10 7.71 2.15 3.35
Saskatchewan 0.55 5.22 5.42 0 1.92 4.61 1.17
Manitoba 0 7.53 5.13 9.33 5.49 4.83 3.66
Ontario 3.46 10 10 7.11 8.32 7.75 7.43
Quebec 10 7.36 8.95 9.33 10 10 10
New Brunswick 6.81 9.1 5.94 7.21 7.83 5.86 5.87
Nova Scotia 5.96 5.89 4.4 6.46 5.73 6.22 4.73
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Labrador
6.68 5.7 3.41 3.92 4.74 0 0
95 IHE IN YOUR POCKET 2014
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96 INSTITUTE OF HEALTH ECONOMICS
Notes
77 IHE IN YOUR POCKET 2014
H
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t
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b
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a
v
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r
s
0 5 10 15 20 25 30 35 40
Spain*
Netherlands
Germany*
Italy
Sweden
United States
Australia^
Finland
Canada
France
Overweight population aged
15 and above
selected OECD countries, 2010
Notes: Self-reported data. *2009 data; ^2007 data.
Source: OECD Stat Extracts. Organization for Economic Co-operation and Development.
Accessed at http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT# on September
10, 2013. www.oecd.org
29.9
33.2
34.1
34.6
35
35.1
35.6
36.8
36.7
37.7
Percentage of population
OECD Average: 34.9
78 INSTITUTE OF HEALTH ECONOMICS
Notes
Health Status
80 INSTITUTE OF HEALTH ECONOMICS
H
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a
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t
h

s
t
a
t
u
s
0 5 10 15 20
Northwest Territories
Nunavut
Yukon
Saskatchewan
Manitoba
Newfoundland and Labrador
New Brunswick
Alberta
Ontario
Canada
Quebec
British Columbia
Nova Scotia
Prince Edward Island
Source: Infant mortality rates, by province and territory (Both sexes). Stats Canada. Accessed
at: http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health21a-eng.htm on May
10, 2013. http://statscan.gc.ca
Mortality rates per 1,000 live births
Infant mortality
Canada, 2009
3.4
3.4
3.6
4.4
4.9
5
5.5
5.8
6.3
6.3
6.7
7.8
14.8
15.5
Source: Infant mortality rates, by province and territory (Both sexes). Stats Canada. Accessed at http://
www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health21a-eng.htm on September 11, 2013.
http://www.statcan.gc.ca
Infant mortality rates per 1,000 live births in Canada
4
5
6
2009 2008 2007 2006 2005
5.4
5
5.1 5.1
4.9
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