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t is estimated that public and private spending on healthcare in Canada topped $95 billion in 2000 and will easily exceed $100 billion in 2001. To put that in perspective, the 2000 amount represents approximately 10% of the entire Canadian expenditure-based gross domestic product. It would seem logical to assume that with so many dollars at stake, the healthcare sector would be a model of sophisticated financial management. Recent evidence indicates this is not the case. In essence, lack of good financial information has been a barrier in optimizing resources and improving transparency and accountability. The Report of the Saskatchewan Commission on Medicare released in April of this year stated that “the health care system is data-rich and information poor. There is little that tells managers, the public or providers about the quality of their labours in relation to agreed-upon goals and standards.” The Financial Management of Acute Care in Canada is a new study sponsored by the Canadian Institute for Health Information and co-written by Ian McKillop, PhD, George H. Pink, PhD, and Lina M. Johnson, MBA. Dr. McKillop is an assistant professor of accounting and information systems at Wilfrid Laurier University; Dr. Pink is an associate professor in the Department of Health Administration at the University of Toronto; and Ms. Johnson is an accomplished researcher. The Executive Summary to the study states that it “provides a comprehensive inventory of practices related to the management of financial resources dedicated primarily to hospital-delivered acute care in Canada for the fiscal year April, 2000 through March 31, 2001.” The authors gathered the information presented in the study from provincial and territorial health ministries and departments between August and November 2000. The study is essentially a cataloguing and sourcebook of practices and as such serves a valuable purpose. To retain its value, the authors will have to update it regularly; for change is the norm in the evolving practices of the healthcare sector. The study should be on the bookshelf of health sector financial folks who will want to compare and contrast financial management practices across the nation. In chapters 2 through 5, the study presents data on funding, performance monitoring and financial reporting approaches in broad fashions. Chapter 7, which accounts for two-thirds of the total contents, presents summaries of background data collected from each of the participating provinces and territories. This chapter in particular is a solid reference source. The presentation throughout is logical and easy to follow. The writing is in the style of an I

Data-Rich and Information- Poor (But Improving) A Look at the Financial Management of Acute Care in Canada