Examining Potential Years of Life Lost
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Canada’s International Health System Performance Over 50 Years Examining Potential Years of Life Lost Production of this document is made possible by financial contributions from Health Canada and provincial and territorial governments. The views expressed herein do not necessarily represent the views of Health Canada or any provincial or territorial government. All rights reserved. The contents of this publication may be reproduced unaltered, in whole or in part and by any means, solely for non-commercial purposes, provided that the Canadian Institute for Health Information is properly and fully acknowledged as the copyright owner. Any reproduction or use of this publication or its contents for any commercial purpose requires the prior written authorization of the Canadian Institute for Health Information. Reproduction or use that suggests endorsement by, or affiliation with, the Canadian Institute for Health Information is prohibited. For permission or information, please contact CIHI: Canadian Institute for Health Information 495 Richmond Road, Suite 600 Ottawa, Ontario K2A 4H6 Phone: 613-241-7860 Fax: 613-241-8120 www.cihi.ca [email protected] ISBN 978-1-77109-510-5 (PDF) © 2016 Canadian Institute for Health Information How to cite this document: Canadian Institute for Health Information. Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost. Ottawa, ON: CIHI; 2016. Cette publication est aussi disponible en français sous le titre Performance du système de santé canadien à l’international sur 50 ans : regard sur les années potentielles de vie perdues. ISBN 978-1-77109-511-2 (PDF) Table of contents Acknowledgements .............................................................................................................................................................................. 4 Executive summary .............................................................................................................................................................................. 6 Introduction .......................................................................................................................................................................................... 8 Our approach ....................................................................................................................................................................................... 9 Study results ...................................................................................................................................................................................... 12 How did Canada perform on overall PYLL relative to OECD comparator countries between 1960 and 2010? ............................. 12 Canada’s PYLL performance over 50 years: Overall, 1960 to 2010 ........................................................................................ 12 How did Canadian men and women perform on overall PYLL relative to men and women in OECD comparator countries? ........ 16 Canada’s PYLL performance over 50 years: Men and women, 1960 to 2010 ......................................................................... 17 How did Canada perform on PYLL for main causes of death relative to OECD comparator countries? ........................................ 20 Canada’s PYLL performance over 50 years: Main causes of death, 1960 to 2010 ................................................................. 21 Canada’s PYLL performance over 50 years: Cancer, 1960 to 2010 ....................................................................................... 22 Canada’s PYLL performance over 50 years: External causes, 1960 to 2010 .......................................................................... 27 Canada’s PYLL performance over 50 years: Ischemic heart disease, 1960 to 2010 ............................................................... 31 Canada’s PYLL performance over 50 years: Cerebrovascular disease, 1960 to 2010 ............................................................ 34 Conclusions ....................................................................................................................................................................................... 39 Appendix A: Methodological details .................................................................................................................................................... 42 Appendix B: Text alternative for images ............................................................................................................................................. 47 References ........................................................................................................................................................................................ 53 Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost Acknowledgements The Canadian Institute for Health Information (CIHI) wishes to acknowledge and thank members of the project team from the Canadian Population Health Initiative for their dedication and contributions to Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost. Team members included Michele (Arthur) Bender, Deborah Cohen, Harshani Dabere, Ezra Hart, Jean Harvey, Kelly Hogan, Mohamed Kharbouch, Gobinaa Manoharan, Maisam Najafizada, Annie Sebold, Thushara Sivanandan and Karen Weir. We would also like to thank the CIHI Advisory Council on Population Health for its ongoing guidance and support, and to extend our gratitude to colleagues from across the organization for their guidance and expertise over the course of the project. We would like to express our appreciation to the members of the expert advisory group, who provided invaluable advice throughout the planning and development of this report: • Ross Baker Professor, Institute of Health Policy, Management and Evaluation, University of Toronto • Raisa Deber Professor, Institute of Health Policy, Management and Evaluation, University of Toronto • Niek Klazinga Professor of Social Medicine, Academic Medical Centre, University of Amsterdam, and Visiting Professor, Institute of Health Policy, Management and Evaluation, University of Toronto • Doug Manuel Senior Scientist, Ottawa Hospital Research Institute, and Professor, Department of Family Medicine, University of Ottawa • Cory Neudorf Chief Medical Health Officer, Saskatoon Health Region Please note that the analyses and conclusions in this document do not necessarily reflect those of the individuals or organizations mentioned above. 4 Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost For more information, please contact Canadian Population Health Initiative Canadian Institute for Health Information 495 Richmond Road, Suite 600 Ottawa, Ontario K2A 4H6 Email: [email protected] 5 Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost Executive summary International comparisons can facilitate cross-country learning to improve health system performance. This study helps paint a picture of Canada’s health system performance relative to that of 17 other high-income countries by comparing trends in mortality over a 50-year period (1960 to 2010). Data from the Organisation for Economic Co-operation and Development (OECD) was used to study potential years of life lost (PYLL). PYLL is a measure of premature mortality that provides an estimate of the additional time a person would have lived had he or she not died prematurely (before age 70).1 This study addressed the following questions: How did Canada perform on overall PYLL relative to OECD comparator countries between 1960 and 2010? This study demonstrated that, like all other countries included in the analysis, Canada made substantial improvements in PYLL, experiencing a reduction of 6,000 absolute potential years of life lost per 100,000 population between 1960 and 2010. However, relative to other peer countries over the 50-year period, Canada maintained a middle-of-the-pack performance. This finding suggests that although Canada is making progress in absolute terms, it is keeping pace with the international median in relative terms. How did Canadian men and women perform on overall PYLL relative to men and women in OECD comparator countries? In terms of overall PYLL, Canadian men and women showed similar patterns of middle-of-the-pack performance in earlier decades; more recently, though, Canada’s performance for men and women moved in different directions. From the 1990s to 2010, Canada’s men were consistently ahead of the international median relative to men in the comparator countries. Conversely, Canada’s women lost ground from the 1990s and in 2010 lagged behind the international median relative to other women. There continued to be a sex gap in Canada for PYLL overall. In 2010 in Canada, men lost almost twice as many potential years of life as women. This sex gap was predominant for certain causes of death. In 2010, absolute PYLL rates for deaths due to external causes were higher among Canadian men than Canadian women, with a male-to-female ratio of almost 3:1. A similar pattern existed for PYLL rates for ischemic heart disease, with a male-to-female ratio of 4:1. 6 Canada’s International Health System Performance Over 50 Years: Examining Potential Years of Life Lost How did Canada perform on PYLL for main causes of death relative to OECD