Conference on Research in Income and Wealth Fall 2012

The paper will develop a cost-weighted output index for the Canadian healthcare sector which can be compared with inputs to measure the productivity performance of the healthcare sector. It uses the approach as outlined in the OECD Handbook on the measurement of the volume output of education and health services (OECD 2010). The paper will cover the three main healthcare sectors: the hospital sector, the office of physicians, and Nursing and Residential Care Facilities.

The data for developing the output index of the hospital sector is obtained from the two micro databases of the Canadian Institute of Health Information: the Discharge Abstract Database (DAD) and the National Ambulatory Care Reporting System (NACRS). The Discharge Abstract Database includes acute care inpatient cases, while the ambulatory care visits are covered in the NACRS. The inpatient cases in the DAD are classified by Case Mix Groups that group acute care inpatient cases with similar clinical and resource utilization characteristics. Ambulatory care visits (or day procedures) in NCARS are grouped by Day Procedure Groups. For each CMG and DPG, the CIHI developed Resource Intensity Weights (RIW) that measures the relative amount of hospital resources. The RIW will be used as weights for estimating Tornqvist index of the hospital sector output.

The data for developing the output index for the office of physicians come from the National Physician Database of the CIHI, which contains data for fee-for-service physician payments in Canada. The data for Nursing and Residential Care Facilities come from Residential Care Facilities Survey of Statistics Canada.

The global crisis of 2008 highlighted the need to understand financial interconnectedness among the various sectors of an economy and between them and their counterparties in the rest of the world. However, application of this kind of analysis has been hampered by the lack of adequate data. This paper sets the background for promoting internationally coordinated efforts for compiling and disseminating data on sectoral financial positions and flows on a from-whom-to-whom basis within the framework of the System of National Accounts. It draws on actual experiences in compiling these kinds of data and provides guidelines for their development in the future.

There is a wide-spread feeling among economists, statisticians and policy makers that society needs to develop measures which go "beyond GDP". Most recently, the publication of the Stiglitz-Sen-Fitoussi Report the call for proper measurement of human well-being and sustainable development has increased considerably. However, the last few decades have seen the introduction of countless composite indicators and indicator sets, none of which has been adopted unanimously as the alternative to GDP.
This paper, based on work that the authors have done within the Taskforce for Measuring Sustainable Development (a group which consists of the UNECE/OECD/Eurostat/World Bank and ten leading countries), describes an indicator system which can describe human well-being and sustainable development appropriately.
The paper developed a conceptual framework which is based on the Stiglitz Report as well as the sustainability concept as put forward by the Brundtland Commission (Our Common Future). The proposed indicator system distinguishes the human well-being for a country in the "here and now", and compares it to the well-being for future generations ("later") and people elsewhere on the planet ("elsewhere").
The first part of the paper deals with the methodological issues concerning the measurement of the three dimensions ("here and now", "later" and "elsewhere"). The section on human well-being in the "here and now" discusses literature on welfarism, subjective well-being as well as Sen's functionings and capability approach. The "later" dimension is described on the basis of the capital approach. The paper strongly focuses on those assets which are not captured in the system of national accounting, i.e. non-market natural capital, human capital and social capital. Last but not least the "elsewhere" dimension discusses different ways in which a country affects other countries in terms of the use of natural capital (through the calculation of footprints).
The second part of the paper identifies to what extent the indicators suggested in the previous section are actually available. On the basis of a careful analysis of a large number of international datasets, a final list of sustainable development indicators is selected. The proposed indicator set enables the user to analyse the fundamental trade off of human well-being of the present generation in a country vis-à-vis the future generation and vis-à-vis people elsewhere on the planet.