The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview

To achieve efficient allocation of resources in the health care sector, accurate measures of health care output and productivity are essential. According to official estimates of productivity produced by Statistics Canada, labour productivity in the business sector of the health care (excluding hospitals) and social assistance industry declined 0.28 per cent per year between 1994 and 2003. Estimates of productivity produced by the CSLS, based on official Statistics Canada employment and real GDP figures, show that labour productivity in the health care and social assistance industry declined by 0.69 per cent per year between 1987 and 2006. It is widely recognized that official output and productivity figures may seriously underestimate the true contribution of the health care sector to real output, and more importantly to the economic well-being of Canadians. Alternative approaches show that price indices for health care output may be overestimated and, therefore, quality improvements may not be accurately captured by estimates of real health care output. More resources are needed to further investigate the alternative approaches discussed in this report and develop better output measures that adjust for outcomes directly related to health care spending.Health sector, Productivity, Measurement, Canada, Outcomes.

Chapitre 2. Les effets du libre-échange entre le Canada et les États-Unis sur le commerce interprovincial

Dix années se sont écoulées depuis la signature de l’Accord de libre-échange entre le Canada et les États-Unis. Lequel fut suivi de l’Accord de libre-échange nord-américain (ALENA), entré en vigueur le 1er janvier 1994. On s’attendait à ce que ces deux accords de libre-échange créent une économie plus compétitive au Canada grâce à une concurrence accrue et à un accès ouvert à un plus grand marché d’exportation. Le Canada ne fut pas le seul pays à conclure des accords commerciaux préférentiels..

Poverty dynamics in eight countries

Despite very different macroeconomic conditions, demographic structures and degrees of income inequality, favorable income changes among low-income families with children were widespread and strikingly similar across the eight countries in our study. In most European countries, the combination of modest inequality and extensive mobility among the poor enabled virtually all families to avoid relative income deprivation at least occasionally. However, even substantial mobility among the poor in the Unites States could not elevate the living standards of one in seven white and two in five black families to a level that was half that enjoyed by a typical American family.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46060/1/148_2004_Article_BF00163068.pd

A multicenter prospective, randomized, placebo-controlled phase II/III trial for preemptive acute graft-versus-host disease therapy

Acute graft-versus-host disease (aGvHD) contributes to about 50% of transplant-related mortality (non-relapse mortality) after allogeneic hematopoietic stem cell transplantation (HSCT). Here the predictive value of a urinary proteomic profile (aGvHD_MS17) was tested together with preemptive prednisolone therapy. Two-hundred and fifty-nine of 267 patients were eligible for analysis. Ninety-two patients were randomized upon aGvHD_MS17 classification factor above 0.1 to receive either prednisolone (2–2.5 mg/kg, N = 44) or placebo (N = 47; N = 1 randomization failure) for 5 days followed by tapering. The remaining 167 patients formed the observation group. The primary endpoint of the randomized trial was incidence of aGvHD grade II between randomization and day +100 post HSCT. Analysis of the short-term preemptive prednisolone therapy in the randomized patients showed no significant difference in incidence or severity of acute GvHD (HR: 1.69, 95% CI: 0.66–4.32, P = 0.27). Prednisolone as preemptive treatment did not lead to an increase in relapse (20.2% in the placebo and 14.0% in the prednisolone group (P = 0.46)). The frequency of adverse events was slightly higher in the placebo group (64.4% versus 50%, respectively). Taken together, the results of the Pre-GvHD trial demonstrated the feasibility and safety of preemptive prednisolone treatment in the randomized patients

La capacité de choisir

L'objectif de ce livre est d'examiner les répercussions de l'intégration nord-américaine sur la vie culturelle, intellectuelle, politique, sociale et économique des Canadiens. Les résultats de cette analyse sont étonnants. On y apprend que l'exode des cerveaux ne correspond pas vraiment à ce que les médias en ont dit ; que les industries culturelles sont une des premières sources de revenus de nos voisins du sud ; que les échanges interprovinciaux, malgré un déclin incontestable (spécialement au Québec), l'emportent très nettement sur le commerce avec les États-Unis ; que les négociations de l'ALENA ont été menées sans consultations du milieu syndical et en parfaite harmonie avec le milieu des affaires ; que le fédéralisme canadien piloté par Ottawa tend à étouffer l'autonomie provinciale et ainsi à s'autodétruire ; que les préoccupations écologiques du Canada sont assez timides par rapport à celles des États-Unis. Dans cette perspective, il faut, selon les auteurs, défendre l'autonomie de l'État canadien dans ses alliances commerciales, sociales et culturelles et faire preuve d'un respect plus prononcé pour les prérogatives provinciales. Faute de quoi, l'avenir s'annonce très difficile