RT Journal Article
SR Electronic
T1 Effect of provincial spending on social services and health care on health outcomes in Canada: an observational longitudinal study
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E66
OP E71
DO 10.1503/cmaj.170132
VO 190
IS 3
A1 Dutton, Daniel J.
A1 Forest, Pierre-Gerlier
A1 Kneebone, Ronald D.
A1 Zwicker, Jennifer D.
YR 2018
UL http://www.cmaj.ca/content/190/3/E66.abstract
AB BACKGROUND: Escalating health care spending is a concern in Western countries, given the lack of evidence of a direct connection between spending and improvements in health. We aimed to determine the association between spending on health care and social programs and health outcomes in Canada.METHODS: We used retrospective data from Canadian provincial expenditure reports, for the period 1981 to 2011, to model the effects of social and health spending (as a ratio, social/health) on potentially avoidable mortality, infant mortality and life expectancy. We used linear regressions, accounting for provincial fixed effects and time, and controlling for confounding variables at the provincial level.RESULTS: A 1-cent increase in social spending per dollar spent on health was associated with a 0.1% (95% confidence interval [CI] 0.04% to 0.16%) decrease in potentially avoidable mortality and a 0.01% (95% CI 0.01% to 0.02%) increase in life expectancy. The ratio had a statistically nonsignificant relationship with infant mortality (p = 0.2).INTERPRETATION: Population-level health outcomes could benefit from a reallocation of government dollars from health to social spending, even if total government spending were left unchanged. This result is consistent with other findings from Canada and the United States.