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Canada ranked 8th among 11 developed countries in seniors' care

As Canada’s population ages at a rapid rate, a new study from the C.D. Howe Institute suggests the country can do more to improve access to seniors’ care and overall equity in the health system.

Released Thursday, the study compares the performance of seniors’ care in Canada and its provinces to that of other wealthy nations using data from the Commonwealth Fund, a U.S.-based foundation dedicated to improving health-care systems, and identifies areas for improvement.

The foundation’s 2021 International Health Policy Survey of Older Adults survey focused on a random sample of seniors aged 65 and older in 11 developed countries and asked about their experiences, interactions and perceptions of the health-care system and health providers.

Among the countries surveyed, Canada ranked eighth in seniors’ care — ahead only of France, the U.K. and Sweden.


Drawing from the survey’s data, the C.D. Howe Institute study applies a magnifying lens to seniors’ care in Canada’s provinces, because, as study co-author Rosalie Wyonch explained in an interview with, “we're really 13 health-care systems, not one.”

The study found that most provinces exceed the international average in care process, which includes factors such as co-ordination across health providers and patient engagement, but fall below average on equity and access to care, which includes factors such as wait times.

It also notes that access to medical care is an obstacle for low-income seniors, noting in the study that 15 per cent of seniors in Canada are not visiting a dentist and eight percent are not receiving the home care they need because they can’t afford it.

Four provinces — P.E.I., Ontario, Manitoba and Alberta — were found to score above the international average overall, while some provinces — particularly Newfoundland and Labrador and Quebec — scored below most international comparators.

Among their policy recommendations, Wyonch and her co-author Tingting Zhang suggest improving overall access to care for seniors, timeliness of care and reducing cost barriers to prescriptions, dentistry and home care services across the country.

“Part of the analysis is how can we push ourselves to be the best of the best?” said Wyonch, who is also a senior policy analyst at the C.D. Howe Institute and leads its Health Policy Council and Research Initiative.

“And so we would do better by reducing wait times and ensuring particularly those that are on the lower end of the income distribution can access care.”


The study also analyzed countries like Germany and the Netherlands that rank higher than Canada in seniors’ care in order to draw inspiration for domestic solutions.

Wyonch notes the Netherlands stands out as being “significantly better” for access to care after regular business hours than the other countries and Canadian provinces.

This, she said, is owing to the fact that physicians in the Dutch country are required to put in at least 50 hours of after-hours care each year to maintain their licences.

Germany, on the other hand, reported the highest health status among seniors.

“Because they're actually better at maintaining the health of their population and doing better prevention, so they are healthier to begin with. So they require less care and that helps with that access and wait times issue,” Wyonch explained.


The federal government projects that the population of seniors, or people aged 65 and above, will increase and reach close to one-fourth of the overall population of Canada by 2040.

Wyonch said this will likely put extra pressure on Canada’s health-care system, further underlying the need for the country to prioritize seniors’ care.

“The need for care is only going to increase over the coming, at least over the next couple of years, before the demographic curve might shift back the other way,” she said.

“But during that time, we need to prepare now to be able to deliver that care or when people need it in the future because it takes years to adapt systems, build buildings, train doctors — most things.”

The COVID-19 pandemic, which exposed cracks in the country’s health-care system, including seniors’ care, and claimed the lives of thousands of seniors, is another reason to be proactive rather than “complacent,” Wyonch said.

“Decades of warnings culminated in the disaster that was the pandemic in institutional care. And so we had lots of prior knowledge and, in my view, we haven't done enough yet to prevent something similar from happening,” she said.

“Most actions in the health-care system won't necessarily see results until a few years into the future. And so if we want to address these things before we have a crisis, we should act sooner rather than later.” Top Stories

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