organized curiosity

Improving health care through research

Sustainability of the Canadian health care system: In “evidence” we trust!

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ShashiLast year when I was at a local Cancer Research Conference, I struck up a conversation with a very sweet, older lady about the status of cancer treatment options in Canada. She told me that she was a breast cancer survivor and felt very lucky to be living in a country that has a publically funded healthcare system. But then, she also expressed that she was not happy about the fact that our hospitals did not have the very latest machine, the one she had heard about in the news that diagnoses breast cancer at early stages. She insisted that we are not spending enough money to get these new technologies.

That conversation really got me thinking about how we perceive our healthcare. Is it really true that Canada does not spend enough on healthcare?

Well, according to the Canadian Institute for Health Information (CIHI), we spent an estimated $211,000,000,000 (yes, that is 211 billion dollars!) on healthcare in 2013.

If we spent such an immense amount of money on healthcare, why are only certain things funded? Why can’t we afford everything that is on everyone’s medical wish list? Or why can’t we just spend more (we are spending $211 billion right now anyways so what’s another few million dollars)?

In reality, we are already spending too much. Most policy makers now agree that at the current rate of expenditure, the Canadian healthcare system will soon become unsustainable. This realization has forced us to make some tough decisions regarding funding.

But who gets to say what to fund and what not to? How do we go about making these decisions in a fair, ethical, and economically sound way without affecting the quality of healthcare?

There is no magical formula to answer these questions. But, one of the most appropriate solutions to achieve sustainable healthcare would be to make our decisions based on the evidence.

So what is evidence? In general terms, evidence is a body of facts that is collected through scientifically valid means of research.

Thus, it is explicit that the generation of evidence requires research activities. However, who performs such research and how it gets decided what needs to be researched?

Traditionally, such evidence was derived by researchers doing their research in academic settings. In this model, researchers do research and policy makers do policies in their respective “silos”. What we have lacked, in most part thus far, is the collaboration between researchers and policy makers. The biggest criticism for this traditional system is that the knowledge synthesized by “researchers” is very academic and lacks the context of the feasibility in the real world which is sought by “policy makers”.

Such disconnect between researchers and policy makers restricts the evidence-informed policy making practices.

Not surprisingly, in recent times many research agencies have explicitly advocated for the active collaboration between researchers and policy makers. This new trend is exemplified by two examples: one at the national level and the other at the local level. The Canadian Institutes of Health Research (CIHR), the Government of Canada’s health research investment agency, launched a new program called the Evidence-Informed Healthcare Renewal (EIHR) to “support researchers and decision makers to work together to advance the current state of knowledge, generate novel and creative solutions, and translate evidence for uptake into policy and practice to strengthen Canada’s healthcare systems.” Similar collaboration between researchers and policy makers is also promoted through the Translating Research Into Care (TRIC) Grants of QEII and IWK Foundations.


It is now clear that the solutions for sustainable healthcare will come through the collaborative efforts between the various components of the system. In this multi-disciplinary model, researchers will work alongside with policy makers and draw upon each other’s expertise to develop academically sound and practically feasible solutions. Only through such an integrated approach, we will be able to produce the evidence that will aid our mission to develop the policies to sustain our healthcare system.

~ Dr. Shashi Gujar, is a scientist with Strategy and Organizational Performance, at the IWK Health Centre, and also works with Faculty of Medicine, at Dalhousie University as a researcher.


One thought on “Sustainability of the Canadian health care system: In “evidence” we trust!

  1. Well said Dr. Gujar!

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