The performance ranking links overall health system achievement to health system expenditure. Canada ranked 7th in overall health-system achievement and 10th in terms of health spending, but fell to 30th when these 2 measures were combined because the methodology considers what could be achieved in a country given the level of resources available.

The WHO assessment of overall health-system achievement was based on the overall level of population health, health inequalities within the population, responsiveness of the system based on patient satisfaction and how well the system performs, how well people of varying economic status feel they are served by the system and the distribution of the health system's costs.

The average level of health — where Canada ranked 12th — is based on disability-adjusted life expectancy or the expectation of life lived in equivalent full health. Distribution of health is measured in terms of child-survival rates across countries. Canada ranked 18th in this area.

Responsiveness of the health system was estimated based on individual surveys that evaluated performance concerning respect of persons (dignity, autonomy, confidentiality) and client orientation (prompt attention, choice of provider, etc). Distribution of responsiveness reflected a country's ability to treat disadvantaged groups such as the elderly and poor. Canada ranked 8th in terms of level of responsiveness and among the top 38 countries (36 countries tied) for distribution.