Principles of Sustainable Health Care

The financial sustainability of the health care system is a major concern, as health care budgets currently consume close to half of provincial budgets. Other concerns for health and health care sustainability relate to health human resources, inequities, safety, citizen’s trust and confidence, productivity, and societal expectations.

Framework for Sustainable Health and Health Care

Image showing the key elements for a sustainable health system
Source: The Conference Board of Canada.

The following are Guiding Principles of Health and Health System Sustainability:

  1. Appropriateness—seeing outcome targets defined, accountability at all levels, and alignment with accreditation and funding.
  2. Value for money—achieving better outcomes from the same investments.
  3. Fair and timely access—limiting barriers to access, financial or otherwise.
  4. Accountability for results—seeing outcome targets defined, accountability at all levels, and alignment with accreditation and funding.

The Pillars of Health Care Sustainability

Optimal development, alignment, and support of human resources

  1. Develop, nurture, and protect formal and informal workforce.
  2. Anticipate and plan for shifts in supply and demand.
  3. Generate innovative delivery models—new professions, roles, better integration, and informal caregivers/resources.

Strategic alignment with determinants of health

  1. Mobilize and coordinate action across sectors to affect demand for Strategic alignment with determinants of health.
  2. Health and health care services.
  3. Sectors/factors that contribute to demand include the social, economic, and physical environments.

Sustainability Defined

Sustainable health and health care is the appropriate balance between the cultural, social, and economic environments designed to meet the health and health care needs of individuals and the population (from health promotion and disease prevention, to restoring health and supporting end of life) and that leads to optimal health and health care outcomes without compromising the outcomes and ability of future generations to meet their own health and health care needs.

The elements of health and health system sustainability are further elaborated in the CASHC foundational report Defining Health and Health Care System Sustainability.