Quality of Care: Public Believes the Care Part of Quality Has Declined Since Last Review

About 8 in 10 Canadians report using healthcare services within the previous 12 months.

The percentage reporting that the quality of care they received was "excellent" has declined by two percentage points between May 2000 and March 2001. The decreases in the "excellent" rating in Quebec, Ontario and Manitoba, Saskatchewan are statistically significant (±5 percentage points).

The increases in "excellent" rating in Alberta and British Columbia are close to statistical significance.

Overall, in March 2001, Manitoba, Saskatchewan healthcare users were the least likely to report that the quality of care they had received was excellent. The only other area to report a similar response was Montreal where again only 24% said they had received excellent quality of care.

Given no external evidence that the standard of clinical care has decreased, it is likely respondents are referring to the "caring" part of quality of care, the personal attention and care they received.

Those least likely to report the care they received was excellent include the more vulnerable groups in our society: those who are ill, those who report they were unable to access health services and unskilled workers.

Accessing Health Services

However, there has been a significant decline since 1989 in the proportions reporting that they eventually received the needed health services.

Nationally, of those experiencing difficulty accessing health services the proportion which report eventually receiving the service has declined from 88% in 1989 to 70% in 2001. All regions show a comparable decline. The largest decline, in percentage points, is in British Columbia where the proportion declined from 93% to 66% since 1989.

Looking to the past few years, the proportion of those accessing health services in the previous year who reported that they did not receive all of the services they thought they needed increased from 12% in 2000 to 15% in 2001, a statistically significant increase.

On a regional basis between 2000 and 2001:

• In Quebec the increase in those not receiving the needed health services from 2000 to 2001 is statistically significant;
  
• In Ontario, the increase is not significant but may be real;
  
• In Alberta and British Columbia the year-to-year changes are not statistically significant, but other data suggest that the differences are, in fact, real; that is, access to health services has become easier in Alberta and more difficult in British Columbia.

This represents about 1,000,000 Canadians who did not receive health services they thought they needed in the previous year.

Effects on health of not receiving needed services

The results are similar to those from previous Monitor surveys: about a third reported their health stayed the same, a third said it got worse, and a third said their health improved.

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