Countries that succeed in reining in health-care costs do well in preventing injuries, says Dr. Jody Heymann. (Darren Calabrese/Canadian Press)

Montreal's McGill University will play a leading role in a worldwide study to examine how to rein in out-of-control health costs and get better results for patients.

The five-year research program, called the Healthier Societies Initiative, will map out what works and what doesn't work in health-care systems in the world's leading economies.

It will then take a close look at the best practices, with the aim of developing more effective and affordable health-care delivery.

"This really would be the first time to look across all these countries in quite a lot of detail at what's working and why," said Dr. Jody Heymann of McGill's Institute for Health and Social Policy.

"Part of the reason why it hasn't been done in the past is because it's not a small undertaking."

Heymann, who is leading the study, points out that health-care costs have been growing "at an unsustainable rate" and rising far faster than gross domestic product growth.

"In Canada in 1975, we were spending seven per cent of GDP and, in 2009, it was 12 per cent," Heymann said.

"We can't keep up that rate of growth in health-care spending and still be able to afford education and everything else that we care about."

A background paper says that while increases in health-care costs have continued to grow, the general health of the population hasn't improved.

The United States is ranked first in health expenditures but 32nd when it comes to female life expectancy and neonatal mortality.

On the other hand, Japan is at the top of the list in life expectancy as well as neonatal mortality, while it ranks 19th on health expenditures.

Heymann said when translated into purchasing power in U.S. dollars, Canadians spend $4,100 per person and Americans spend $7,500. In Japan and New Zealand, the amount is just $2,700.

Life expectancies

But Canadians don't have a much better life expectancy than the Japanese even though almost 50 per cent more is spent on health care.

Heymann points out the average life expectancy in Canada is 80.7 years while in Japan, where health spending is less, life expectancy is two years higher — 82.6 years.

And while the United States is spending the most on health care, life expectancy is under 78 years.

"It's not just health-care spending that gets you better health," she said. "It matters what you're doing on prevention on the public health side, it [also] matters what your social conditions are."

Heymann predicts the detailed study, which will bring together academics from across North America and Europe, will result in a number of lessons.

Prevention lessons

"The countries that succeed succeed because they managed to do well in terms of preventing illness and injury," she said.

Heymann notes that diabetes has more than tripled over the past two decades.

The number of diabetics in Canada went from 1.3 million in 2000 to 2.5 million now. By 2020, it's estimated there will be 3.7 million diabetics.

"People would rather not get diabetes in the first place, so part of the answer is likely to lie in doing a better job at the prevention side," Heymann said.

"The second lesson that will be learned is: once people are sick, can we manage the costs more efficiently?"

The internationally renowned researcher suggests the countries that are doing well likely manage their health-care costs better.

Administrative costs account for almost 17 per cent of health expenditures in Canada, while in the United States it's more than 30 per cent.

The project's preliminary phase will compare health-care costs across provinces and countries, look at historical trends and examine projections for the future.

McGill says the research will provide students from around the world training opportunities and skills to translate any of their findings into policy change.