1. Quality of care Patient-centred primary and specialist care Medication reviews Chronic condition management and disease prevention 1

2. When older Canadians needed care or treatment, their regular doctor always or oftenCanadaCMWF average Knew important information about their medical history Spent enough time with them Encouraged them to ask questions Most older Canadians have a positive experience with their regular doctor 87% 82%86%70%66% Compared with the CMWF average Above averageSame as averageBelow average 2

3. Patient-centred care from specialists is also relatively good in Canada When specialists provided care or treatment, they always or oftenCanadaCMWF average Told patients about treatment choices Involved patients as much as they wanted to be in decisions about treatment or care 72% 79%77% Compared with the CMWF average Above averageSame as averageBelow average 3

4. In the past 2 years, was there a time whenCanadaCMWF average A specialist did not have basic information or test results from the patient’s regular doctor about the reason for the visit A patient’s regular doctor did not seem informed and up to date about the specialist care received However, continuity of care between regular doctors and specialists can be improved 13%9%25%18% Compared with the CMWF average Above averageSame as averageBelow average 4

5. How do the provinces compare? B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Regular doctor always or often Knew important information about patients’ medical history 88%86%89%84%86%89%87%85%87%84%87% Spent enough time with patients 81%80% 79%81%87%80%85%80%78%82%86% Encouraged patients to ask questions 72%70%64%65%68%76%68%66%72%62%70%66% Specialists always or often Told patients about treatment choices 74% 75%78%77%58%73%76%80%77%72% Involved patients as much as they wanted to be in decisions 81%79%83%76%80%76%81%85%88%79% 77% Compared with the CMWF average Above averageSame as averageBelow average 5

6. How do the provinces compare? B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Specialist did not have basic medical information from primary doctor 8% 11%10%26%13%6%4%9%13%9% Primary doctor did not seem informed or up to date about care from specialist 16%18% 46%22%10%13%10%25%18% Continuity of care between primary doctors and specialists was comparable to the international average in most Canadian provinces. Compared with the CMWF average Above averageSame as averageBelow average 6

7. Medication reviews are common for older Canadians How does Canada compare (2014)? Source Canadian Institute for Health Information. Drug Use Among Seniors on Public Drug Programs in Canada, 2012: Revised October 2014. Ottawa, ON: CIHI; 2014. said a health care professional reviewed their medications in the past 12 months. 80% In Canada, seniors use an average of 7.2 prescription drugs in a year. 7

8. Canadians are more likely to have discussions about medication use In the past 12 months, has a health care professional Provided a written list of all medicationsExplained potential side effects 8

9. Patient safety incidents related to medication use are common in Canada Source Canadian Institute for Health Information. Drug Use Among Seniors on Public Drug Programs in Canada, 2012: Revised October 2014. Ottawa, ON: CIHI; 2014. Proportion of seniors on public drug programs taking a potentially inappropriate (Beers list) drug, 2012 Source Canadian Institute for Health Information. Adverse Drug Reaction–Related Hospitalizations Among Seniors, 2006 to 2011. Ottawa, ON: CIHI; 2013. Almost 140,000 hospitalizations for adverse drug reactions among seniors between 2006–2007 and 2010–2011 39% 9

10. How do the provinces compare? In the past 12 months, has a health care professional B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Reviewed all medications 77%78% 75%83% 75%66%77%65%80%70% Explained potential side effects 72% 67%76% 67%70%68%62%74%59% Given a written list of all medications 59%58% 51%67%80%66%62%57%54%67%57% Across provinces, medication management among older patients was equal to or better than that in other countries, on average. Compared with the CMWF average Above averageSame as averageBelow average 10

11. Older people with chronic conditions whoCanadaCMWF average Had discussions about main goals or priorities with their health providers Received clear instructions about symptoms to watch for Care to help manage chronic conditions is above average in Canada *Chronic conditions include hypertension or high blood pressure; heart disease, including heart attack; diabetes; asthma or chronic lung disease such as chronic bronchitis, emphysema or chronic obstructive pulmonary disease; depression, anxiety or other mental health problems; cancer; and joint pain or arthritis. of older Canadians had at least 1 chronic condition* (CMWF average 71%). 78% 60%55%60%56% Compared with the CMWF average Above averageSame as averageBelow average 11

12. However, there is room to improve across countries Source The Commonwealth Fund, 2012 Commonwealth Fund International Survey of Primary Care Doctors. CanadaCMWF average People with chronic conditions who received a written plan for self-management from their health provider 37%35% 21% Routinely Occasionally 58% 21% of family physicians routinely gave their patients with chronic conditions written instructions for self-management. 12 Compared with the CMWF average Above averageSame as averageBelow average

13. Hospitalizations for chronic conditions are declining in Canada but vary widely across the country ACSC hospitalization rates (per 100,000) Source Canadian Institute for Health Information. Your Health System. http://yourhealthsystem.cihi.ca/. Accessed November 27, 2014.http://yourhealthsystem.cihi.ca/ Canadian rates Compared with the Canadian average Above averageSame as averageBelow average 13 Ambulatory care sensitive conditions (ACSCs) are chronic conditions that—when treated effectively in community settings—should not, in most cases, lead to hospitalization.

14. How do the provinces compare? B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. Discussed with patients their main goals or priorities in caring for this condition 59% 61%57%61% 56%60%61%58%60%55% Given patients clear instructions about symptoms to watch for and when to seek further care or treatment 56%57%60% 58%68%62%58%62%58%60%56% Given patients a written plan to help them manage their own care 42%32%36%34%35%38%35%41%42%39%37%35% In the past 12 months, has a health professional In most provinces, management of chronic conditions was similar to the international average experience. Compared with the CMWF average Above averageSame as averageBelow average 14

15. Discussions about healthy life habits are more frequent in Canada During the past 2 years, has a health professional discussed Source The Commonwealth Fund, 2010 Commonwealth Fund International Health Policy Survey. But they happened less often in 2014 than they used to. 15

16. Canada leads in smoking cessation discussions How does Canada compare (2014)? Source OECD Health Statistics 2014. of older Canadians who smoked said a health professional talked to them about the health risks of smoking or using tobacco and ways to quit. 78% 17% of older Canadians smoked, higher than the CMWF average. Lung cancer mortality rates were among the highest in the world for Canadian women at 46 deaths per 100,000 population. 16

17. How do the provinces compare? B.C.Alta.Sask.Man.Ont.Que.N.B.N.S.P.E.I.N.L.Can.CMWF Avg. A healthy diet and healthy eating 54%52%49%47%52%48% 52% 47%51%43% Exercise or physical activity 60%55%52%51%55% 49%54%55%51%55%48% Things in life that worry patients or cause stress 27%23%25%24%26%20%22%32%22%24%25%23% Health risks of smoking or using tobacco and ways to quit 92%75%66%84%79%71%72% 60%59%78%63% During the past 2 years, has a health professional discussed Compared with the CMWF average Above averageSame as averageBelow average 17