Abstract

Research studies in the past have indicated that people in the healthcare system are more satisfied with the system than non-users. Indeed, POLLARA has conducted some of these studies. However, results from a massive new survey of the Canadian public* indicate that satisfaction is neither widely nor deeply held. The survey of a representative sample of 2,239 Canadian adults undertaken in the spring of this year indicates that Canadians who have been in emergency rooms or were hospitalized in the past year are significantly less likely to have had their expectations met than people who have used other types of healthcare service.

These unmet expectations are translating directly into attitudes and opinions about the quality of healthcare. Canadians are three times more likely to say that the quality of healthcare services is worsening rather than improving, as the figure below indicates.

The 49% who say that quality of healthcare is worsening are more likely to have accessed the healthcare system in the past year (52%) than not (42%). In fact, 57% of individuals who have accessed the healthcare system themselves and have had family members in the system say that the quality of healthcare is worsening. The predictions that hospital managers and trustees made years ago about consumer opinion, once the impact of reductions in funding worked their way into the system, are coming true.

This pessimistic group often bases its view on personal experience and experiences of family and friends rather than news media. Personal experience, the most powerful, emotive and lasting form of communication, is driving pessimism about the healthcare system more than indirect forms of contact, such as issues communicated through the news media.

This trend intensifies with age. This is not surprising, but bears notice. The older one is, the more likely the individual is to base his or her view of the healthcare system on personal experience.

What is more, results in this survey indicate that hospital care users are more likely to say that the quality of healthcare is worsening than users of other types of care or non-users.

Those who say that the quality of care is declining, when asked to say in their own words who is most responsible, blame governments - both provincial and federal - in equal and overwhelming numbers. Healthcare providers are singled out by only 6% of Canadians as being responsible for declining care quality.

Consequently, patients in general, and hospital users specifically, are significantly more likely to be looking for new options and alternatives to enhance access to healthcare.

These options include more private clinics, which majorities of users and non-users alike see as providing a much-needed supplement to enhance access to healthcare in Canada.

In every region of Canada, a majority of respondents say that private health services, such as MRI clinics, should be increased rather than cut back. Increased accessibility and availability of care is the main reason underlying this majority preference. On the other side of the same coin, another 10% cite an unfulfilled need or demand.

In summary, demand continues to build for greater access to healthcare, and Canadians are becoming increasingly frustrated with what they perceive as the inability of governments to resolve those demands in the current healthcare system. This survey indicates that large numbers of Canadians are turning toward the private sector to supplement a system of public administration that they believe is not working as promised. Consumers, and in particular hospital consumers, are leading the way on this issue. What does this mean for the future?

More on this and related issues next quarter.

About the Author

Don Guy is Senior Vice President with POLLARA Inc.

Acknowledgment

*Survey commissioned by the 20/20 Healthcare Coalition made up of companies interested in fostering a national debate including PPI Financial, Assure Health and Canadian Association of Insurance and Financial Advisors.