Quebec’s health system has become the lowest-cost provincial health system in Canada while still maintaining health indicators that are among the country’s best, thanks to the adoption of more efficient management practices, said Yves Bolduc, Minister of Health and Social Services of Quebec, in a presentation this week at the Pan American Health Organization (PAHO) in Washington, D.C.

Like the rest of Canada, Quebec provides universal health coverage to its residents. But the sustainability of its system has been threatened by the increasing costs of care for an aging population with high incidence of chronic diseases. To keep costs in line with economic growth, the Ministry of Health and Social Services has adopted an approach known as “lean management,” originally used in the automobile industry. The approach focuses on eliminating practices that are ineffective or wasteful, allowing decision-making by those who are “closest to the action,” and promoting coordinated teamwork among health professionals to eliminate unnecessary referrals and improve patient outcomes.

These improvements have made Quebec’s system “one of the best healthcare systems in the world,” said Bolduc. Other important elements include an emphasis on integrated care models, computerized record keeping, and the use of tele-medicine to improve access to care in remote areas.

The improved efficiencies have reduced Quebec’s annual growth in healthcare costs from 5.7 percent in 2009-2010 to a projected 5 percent over the next three years.

“Some countries have very good health systems but are not able to pay for them in the long term,” said Bolduc. “There is no perfect health system, but we are striving for both excellence and sustainability.”