Comparative analysis of health system performance in Montreal and New York: The importance of context for interpreting indicators

Michael Gusmano, Erin Strumpf, Julie Fiset-Laniel, Daniel Weisz, Victor G. Rodwin

Research output: Contribution to journalArticle

Abstract

Although eliminating financial barriers to care is a necessary condition for improving access to health services, it is not sufficient. Given the contrasting health systems with regard to financing and organization of health insurance in the United States and Canada, there is a long history of comparing these countries. We extend the empirical studies on the Canadian and US health systems by comparing access to ambulatory care as measured by hospitalization rates for ambulatory care sensitive conditions (ACSC) in Montreal and New York City. We find that, in New York, ACSC rates were more than twice as high (12.6 per 1000 population) as in Montreal (4.8 per 1000 population). After controlling for age, sex, and number of diagnoses, significant differences in ACSC rates are present in both cities, but are more pronounced in New York. Our findings are consistent with the hypothesis that universal, first-dollar health insurance coverage has contributed to lower ACSC rates in Montreal than New York. However, Montreal's surprisingly low ACSC rate calls for further research.

LanguageEnglish (US)
Pages101-118
Number of pages18
JournalHealth Economics, Policy and Law
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Ambulatory Care
Systems Analysis
Health
Health Insurance
Insurance Coverage
Population
Health Services
Canada
Hospitalization
Organizations
Research

Cite this

Gusmano, Michael ; Strumpf, Erin ; Fiset-Laniel, Julie ; Weisz, Daniel ; Rodwin, Victor G. / Comparative analysis of health system performance in Montreal and New York : The importance of context for interpreting indicators. In: Health Economics, Policy and Law. 2019 ; Vol. 14, No. 1. pp. 101-118.
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Comparative analysis of health system performance in Montreal and New York : The importance of context for interpreting indicators. / Gusmano, Michael; Strumpf, Erin; Fiset-Laniel, Julie; Weisz, Daniel; Rodwin, Victor G.

In: Health Economics, Policy and Law, Vol. 14, No. 1, 01.01.2019, p. 101-118.

Research output: Contribution to journalArticle

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