Getting to Know Health Indicators
Indicators are a part of everyday life. In your car, indicators like the check engine
light and temperature gauge alert you to potential issues with the engine.
In your home, the battery icon on your cellphone or tablet gives you an idea of how much power
and time you have left. For a country, indicators like unemployment
rates, the gross domestic product, and the consumer price index shed light on the state
of the economy. While others tell you things about the people
living there, like rates of homelessness, education, literacy or income.
Getting the picture? In the health sector, indicators can tell
you about the quality and effectiveness of various interventions or treatments. They
can tell you about health outcomes, quality of care, and even how well public money is
being spent. But what exactly is an indicator?
An indicator acts like a flag that draws your attention to something that’s going on and
makes you ask questions. Questions like…
• What does this number mean? • Why did we get this result?
• When we look at trends, are we getting better over time?
• Are we providing the right care? • How are we doing compared to benchmarks,
peers or others? An indicator provides a standard way of measuring
and comparing a problem or area of focus. This standard and comparable information helps
you understand how well you’re doing and where you could improve.
At CIHI, we’re in the business of developing, calculating and reporting on health indicators.
Things like: health status, mortality rates, returns to hospital, the cost of a standard
hospital stay, rates of pressure ulcers in long-term care, wait times, and rates for
specific procedures like hip replacements. These indicators are expressed in quantitative
terms and help you measure things like safety, quality and appropriateness of care, and efficiency
— and to give you a basis for comparisons. So health indicators are vital tools to help
anyone who monitors and manages the health of a population and how services are being
used. They help staff at all levels of our health
systems understand performance at a pan-Canadian, regional, organizational, and even a program
level. And in fact, there are different kinds of
indicators for different kinds of audiences. Let’s look at a few examples.
Hospitals use the Hospital Deaths — or HSMR — indicator to measure and monitor the quality
of care they’re providing. Staff in long-term care facilities use the
Potentially Inappropriate Use of Antipsychotics in Long-Term Care indicator to identify areas
for improvement and to evaluate performance improvement initiatives.
And the Smoking indicator, which measures the percentage of people in a specific population
who smoke, helps regions determine the effectiveness of their smoking cessation initiatives.
It’s also important to understand that different health indicators are calculated in different
ways, depending on their purpose and intent. Some are simple, while others require more
sophisticated analysis. Some tell you about proportions; others are standardized or risk-adjusted
rates. But all good indicators are based on a specific
set of standard criteria, so that they measure what they claim to measure, and allow you
to compare results in a way that lets you know you’re comparing apples to apples.
A single indicator can’t give you the whole story. It’s just the tip of the iceberg.
In other words, health indicators don’t provide solutions; rather they give clues
to what’s behind the performance. So they’re really just a starting point for further investigation.
But they’re a great tool for providing high-level comparative information on key issues.
So you should really look at a variety of indicators that work together to get a bigger
picture about health system performance, and to support quality improvement and accountability.
Now that you know a bit more about health indicators and the value they provide to stakeholders
at all levels of our health systems, why not put them to work for you? Visit CIHI’s website
and learn more about the indicators, data and tools we provide to help support better
decisions that lead to healthier Canadians.