The Health Council of Canada invites you to submit an abstract

The Health Council of Canada is hosting a national symposium on October 10, 2012, to bring together policy makers, health system planners and administrators, health care providers, educators, researchers and people who use health services, to identify, share and promote the spread of innovative practices in integrated care.

We are currently accepting abstract submissions for oral presentations at the symposium.

We want to highlight innovative health care practices and programs that are being implemented at the local, regional and/or provincial/territorial level. Tell us how your practice and/or program has resulted in better integration of health care services. Share insights from the perspective of people who use health services (e.g. patients and their families, residents in long-term care settings), health care providers, health system planners and administrators, educators, and researchers.

To submit your abstract, Review our Guidelines for Abstract Submission and download the Abstract Submission Form (Available in Word and PDF format). Abstract submission deadline is Monday July 30, 2012 at 11:59 p.m. EST.

“Compassion fatigue” and caregiver burnout

An article in last week’s National Post discussed “compassion fatigue” – a health risk that family caregivers too often experience.

The article describes the high potential for caregiver burnout, saying as the length of time of caregiving increases, the risk of burnout does as well. Dr. Jacqueline Brunshaw, the author of the article, provides tips for caregivers to protect their own health, like understanding the challenges of the situation, celebrating the good times had with the family member, and asking for help.

Caring for a high-needs senior in particular may stretch family caregivers beyond their capacity when there is only limited outside support. We have recently reported on the state of home care in Canada, both in Seniors in need, caregivers in distress, and our Progress Report 2012. We found that about 40-50% of seniors with the most complex health needs have distressed caregivers who report they are finding it difficult to continue to provide care, and that they have feelings of stress, anger, and depression.Home care is an integral part of the health care system, and in order to help ensure the best quality of life for seniors and avoid “compassion fatigue” by their caregivers, it must be supported and enhanced.  

Dr. Brunshaw lists 10 signs of caregiver burnout. If you recognize them in yourself or someone else, you may wish to discuss them with a professional:

1)    Feeling unusually tense, irritable or agitated with others
2)    Being irritable and angry towards the ill/disabled individual
3)    Feeling sad, tearful or dissatisfied with life in general
4)    Feeling exhausted and overwhelmed
5)    Withdrawal from friends and enjoyable activities due to loss of desire and/or energy
6)    Lowered immunity: getting sick more often and taking an unusually long time to recover
7)    Increased need for medications and/or use of drugs or alcohol
8)    Feeling out of control in attempts to manage your usual daily routine, with no sense of how to regain that control any time soon
9)    Trouble sleeping and/or disturbing dreams
10)  Change in appetite

The Future of e-, m-, tele-health: Integration

Don Newsham is  CEO of  COACH: Canada’s Health Informatics Association.

Whatever your current acronym of choice when it comes to technology and health care, there is a huge need to integrate the eHealth, mHealth and telehealth services to target accurate, timely, comprehensive and accessible data, all focused on and serving the patient and his or her health care providers. Telehealth is one of those key foundations; it has now grown up and is ready to be that integral part of providing health care from a distance.

I never cease to be amazed at the usage statistics in our device-happy world. From the now often quoted 6 billion cell phone devices worldwide, to the expected 15 billion network-connected devices by 2015, to the 62% of primary care physicians owning a smart phone (with over 80% using such for professional purposes), it seems that BYOD (bring your own device) is so very real for work wherever you are. [All these stats are taken from presentations at the Spring 2012 Forum on Emerging Technologies, presented by COACH and the BC Health Information Management Professionals Society (BCHIMPS)]. No matter what stats you believe, our electronic world is advancing incredibly.

In Canada, telehealth alone has impressive stats on usage.  We are an ideal setting to use the technologies of the Internet and many telehealth-supported devices for our rural and remote regions, communities and peoples. The Ontario Telemedince Network (OTN) is achieving excellent results in providing clinical services remotely across the province, as are many other provincial telehealth programs, east and west. But what happens to all the good data captured in that clinical session?  And what happens when the patient returns home? How does the health care provider know what happened four virtual patient visits ago?

With some telehealth leaders espousing the virtualness of much or our health technology use and associated electronic records, it seems clear to me that we need and are starting a convergence of our eHealth-based platforms, mobile health devices and telehealth services.  And, we must always think from the patient’s view first.
 
What if I’m in Fort Severn, a First Nations community on Hudson Bay and the most northern community in Ontario, needing resolution to a major diabetes issue? (Note: I have been there with KO Telemedicine.) Yes, I could fly to Sioux Lookout, then on to Thunder Bay for a clinic assessment of the bruising and numbness in my extremities. But the local nursing clinic has great telehealth access to specialists “down south” and I can receive quick assessment and treatment. So, the patient stays in Fort Severn, gets an update on his/her blood glucose levels and requires frequent monitoring of those levels over the next few days. Living outside of town, with poor access over spring breakup – OK, stretching the scenario here, but stick with me – he takes home a glucometer that links to his iPhone and three times a day sends his readings to the specialist and his EMR system, along with pictures of his bruises to the specialist’s iPad. Three days later, the readings are returning to normal and the bruising and numbness is subsiding. The specialist, in touch daily by email, sends a record of the care to the GP’s electronic medical record (EMR) and a scheduled booking for the GP’s next community visit in a week; the patient continues being restored to better health.

This scenario, albeit contrived, demonstrates the use of all technologies of eHealth (EMRs, scheduling, clinical data record of tests and pictures), mobile health (iPhone connection to glucometer and to the physician, with his iPad and BlackBerry for evening readings response) and telehealth (direct interaction with the specialist from a remote community clinic). However, this only works in reality and in real health care interactions with an integrated set of services, data and technologies. Drop one of those “e” services and the patient care flow breaks down.

Telehealth needs the data capacity of eHealth solutions and the electronic health records system platforms now being implemented in provinces and territories across Canada. The common vision led by Canada Health Infoway and implemented in our jurisdictions fully includes health care at a distance – telehealth. And telehealth needs to incorporate the data capture and exchange in a standardized and structured manner that provider EMRs can receive. Similarly, mobile device connectivity to those platforms, whether home health monitoring devices or personal devices, must be facilitated in an interoperable and safe manner.

I’ve no doubt that many health informatics professionals, in hospitals, regions, clinics and vendor organizations, are demonstrating or planning this level of integration right now. We need such integration, ubiquitously implemented and adopted across all parts of Canada. I’m excited that the leadership in our telehealth community has already recognized, envisioned and begun to deliver integrated solutions to serve the needs of patients at any distance from their health care provider. I’m more than pleased that COACH has a telehealth forum (CTF) that provides leadership, education and services in promoting the practice and adoption of telehealth in Canada. We have the foundations of “e”, “m” and “t” health, and now we’re moving to an integrated support of health care where those technologies are fully unified and adopted for all patient services and information, enabling the transforming and sustaining of health care in this great country.

Optimizing the benefits of Telehealth

Simon Hagens is Director, Benefits Realization, Canada Health Infoway.

Thanks to the Health Council of Canada for putting a focus on the progress made in Telehealth and emphasizing the role of measurement and evaluation in informing and shaping successful projects.  A focus on benefits realization is an important aspect of Infoway’s strategy.  Evaluations help us to identify and invest in approaches which are delivering value to patients, clinicians, and the health system as a whole, and also help us to identify the enablers required to unlock the full potential.  This has been very true of our Telehealth investments, as detailed in our 2011 report on Telehealth Benefits and Adoption.
 
Telehealth is truly becoming a mainstream healthcare delivery channel.  We are excited about this progress, and very optimistic about future advances with respect to Telehealth technologies.
 
As the Council report describes, Canada is an international leader in using videoconferencing to provide access to a variety of health care services across our vast geography.  Virtually every jurisdiction has an established telehealth network in place. Recent analysis indicates that the 35% growth rate (annual year over year growth, since 2005) of these services has continued through 2011.  The value of telehealth is becoming increasingly evident to Canadians living in rural and remote areas, some of whom can now access specialist expertise right in their homes and communities, avoiding costly and inconvenient travel to urban centres.

The potential of Telehealth goes far beyond videoconferencing, however, and our more recent Infoway investments support promising innovations that evaluations show are enabling the transformation of the health system.
 
For example, telehomecare is combining telehealth technology and home care principles as a new model for supporting chronic disease management. Telehomecare uses sophisticated easy-to-use equipment to link patients with health care professionals.  It empowers patients to self-manage their chronic illnesses, thereby reducing hospital and emergency room visits.  A new study in Quebec (French only) found equivalent savings of $1,368 per patient annually with telehomecare compared to traditional home care.  A drastic reduction (61%) in hospitalization rates, as well as reduced average length of stay is key to the health system, and for patients it’s all about access to the support they need to manage their own health.  This study strengthens existing Canadian evidence and also reflects international research.

Secondly, telepathology is being used in some provinces to share specialized expertise. For example, 21 sites in Quebec are now operational with slide image scanners. When the community of Sept-Îles lost their only on-site pathologist, the local hospital was able to continue providing surgical services as usual by accessing specialist pathologists at a regional pathology centre via telepathology.   One of our recent investments will allow expertise to be accessed across provincial borders.  The Multi-Jurisdictional Telepathology (MJT) Project will create provincial hubs within Manitoba, Newfoundland & Labrador, and Ontario, and then develop a network of pathology reference centres across Canada to facilitate consultation among sub-specialists.
   
The examples above in telehomecare and telepathology illustrate the future potential for these technologies to improve patient access and to improve the flexibility and sustainability of the health system in these areas and others.  In both cases, evaluations are showing that getting the technology right is important, but optimizing the benefits also requires attention to broader changes, such as evolving roles of clinicians and support staff, patient engagement, and policy change.  The Council report rightfully celebrates what has been achieved, and reminds us to maintain a focus on using technology as an enabler for better health and healthcare.
(shagens@infoway-inforoute.ca)

Telehealth in Canada – A Real eHealth Success Story

John Schinbein is the Executive Director of COACH’s CTF: Canadian Telehealth Forum.

It is no surprise to anyone in the health care system that we are struggling to meet the seemingly never-ending demand.  The costs of health care continue to skyrocket and, increasingly, there are just not enough care providers – didn’t anyone read Boom Bust Echo?

So, decision makers are looking for proven strategies to reduce costs, improve access, quality and productivity.  Technology has been identified in all the health system studies as an important tool to help reform the system. But, based on experience, many decision makers are often weary of technology investments; they want to see demonstrated ROI and tangible benefits.  As anyone involved in technology implementations knows, historically you couldn’t have “Good, Fast and Cheap” – if you were diligent you might get two out of the three. The majorities of technology projects were late, over budget or more generally failed to meet expectations.  There are always exceptions. Recent studies by the CTF: Canadian Telehealth Forum and Gartner, Inc./Praxia Information Intelligence, as commissioned by Canada Health Infoway, have clearly shown that telehealth is proving to be a welcome exception to the old technology maxims. 

The studies highlighted some incredible results:

•    In the last five years the use of telehealth in Canada has grown at an astounding rate, averaging 35% per year over the last 5 years.
•    In 2010, there were nearly 260,000 telehealth events in Canada delivered through 5,710 telehealth systems, to at least 1,175 communities.
•    Rural and remote patients saved an estimated 47 million kilometers of travel in 2010, resulting in an estimated cost savings of over $70 million.
•    Access was improved by reducing wait times for a number of specialties, in some cases, from months to days. 
•    Quality was improved – a number of Telestroke programs have demonstrated that, in about 20% of consultations, tPA was able to be administered in rural hospitals within the critical 3-hour window, with outcomes comparable to patients treated at major hospitals.
•    Telehealth contributes to reducing demand by reducing avoidable health system utilization by an estimated $55 million in 2010.
•    Telehomecare helped the health system avoid an estimated $21 million in hospital utilization.
•    Governments saved an estimated $34 million through reduced medical care related travel and subsidies.
•    More than 80% of patients reported satisfaction with telehealth vs. face-to-face visits with their care provider.
•    If the growth of telehealth continues as it has over the last 5 years, Gartner/Praxia predict it could mean additional benefits to the Canadian health system valued at approximately $730 million, and an additional $440 million in cost avoidance for patients.

With ever-increasing ubiquity and lower costs of technology, especially mobile devices, light applications and the Internet, telehealth is no longer restricted to facilities, expensive video conferencing equipment and wired networks. In fact, health care systems in many third world countries are now benefiting from this lighter and cheaper technology and using telehealth to provide many health services.  While traditional telehealth such as video conferencing and store and forward will continue to expand, I believe the real growth will be in the mobile sector and its use for supporting care for those with chronic disease such as congestive heart failure, diabetes, asthma, and hypertension.  Using mobile technology to deliver health services does, however, bring with it increasing challenges for professional service policies, privacy and security, but these are not insurmountable.

Telehealth continues to capture interest across Canada and the world – Canada is seen as world leader in telehealth use, as evidenced by the number of foreign delegations that come here to learn from our world class telehealth networks. Additionally, the CTF Canadian Telehealth Report received significant attention both in Canada and internationally. It received more than 60 media mentions, including a segment on Canada AM. It was also mentioned on or cited in 111 different websites and publications, with significant mentions in a number of Australian, Spanish, and U.K. publications.

Telehealth is already contributing to a better health care system in Canada by improving access, quality and productivity. When coupled with other eHealth components, such as electronic health records, it has the ability to help transform our struggling health system. CTF members can be justifiably proud of their contributions in helping to bring telehealth into mainstream delivery of health care. The path ahead will, no doubt, have its cracks and bumps, but a good foundation has been laid and the evaluations to date suggest that all three of the goals “Good, Fast and Cheap” are within reach.

Progress on HHR issues?

Ivy Lynn Bourgeault, PhD, is a Professor in the Interdisciplinary School of Health Sciences at the University of Ottawa and the Canadian Institutes of Health Research Chair in Health Human Resource Policy. She is also the Scientific Director of the pan-Ontario Population Health Improvement Research Network and the Ontario Health Human Resource Research Network both housed at the University of Ottawa. Dr. Bourgeault also leads the pan Canadian Health Human Resources Network. Dr. Bourgeault has garnered an international reputation for her research on health professions, health policy and women’s health.

Can our progress towards more effective and efficient use of health human resources (HHR) be seen as a case of a glass half full or half empty – or is it that any progress should be seen as only a drop in the bucket of what is actually possible?  The conclusions that the Health Council of Canada has reached in regards to HHR issues in its Progress Report are correct.  We in Canada have ‘succeeded’ in increasing the supply of HHR (indeed to the point where we are hearing calls of surpluses and underemployment of some medical specialists [see http://spph.ubc.ca/sites/healthcare/files/Media/BelluzDoctorSupplyMedPost-Jan2012.pdfhttp://spph.ubc.ca/sites/healthcare/files/Media/BelluzDoctorSupplyMedPost-Jan2012.pdf]), but we have done so while neglecting to attend to the appropriate mix of HHR and other measures to ensure that existing, highly trained health professionals are working to their full scope of practice. 

The issue of scope of practice is increasingly being highlighted at important policy tables, the Council of the Federation being just one [see http://www.hhr-rhs.ca/index.php?option=com_content&view=article&id=185&lang=en]. Being able to work to full scope is not only important for the productivity of the health workforce, it is a critical element in efforts to retain highly qualified staff (yet another neglected issue). We have also improved collaborative practice and education initiatives – through the investment and successful efforts of the CIHC,  which is no longer being funded – but there has been little interprofessional planning of HHR supply and distribution. That is, any improvements in planning models are still limited by geographic and professional isolation. So we’ve done much less than we could in strengthening the evidence base for national planning and even less to foster closer collaboration across sectors critical in the planning process. 

We are disappointed that repeated calls to establish a pan-Canadian HHR observatory – echoed by all stakeholders and members of the Parliamentary Committee on Health in 2010 – has not been heeded 

[see http://www.parl.gc.ca/content/hoc/Committee/403/HESA/Reports/RP4631326/hesarp06/hesarp06-e.pdf]. Such an observatory would, as described by the WHO, collect, analyze and translate data and information on the health workforce, facilitate a dialogue among HHR stakeholders, and contribute to policy development and a broader understanding of HHR issues.  It is in this vacuum that we have been attempting to create some much needed research and knowledge exchange tools at the pan-Canadian HHR Network, with pilot funds received from Health Canada and the CIHR.  It is our intention to make evidence more accessible to those making critically important HHR decisions and to help sustain our publicly funded health system.

Better local connections will make better nationwide indicators

Dr. Gary Teare joined the Health Quality Council (Saskatoon, SK) in January 2005 as Director of Quality Measurement and Analysis. At the Health Quality Council, Gary leads a team of researchers and analysts in the Council’s work of measuring and reporting on the quality of health care in Saskatchewan and helping to develop performance measurement capability in the health system.  Gary’s own research has largely focused on issues of health care performance measurement.

As we approach the denouement of the “10-Year Plan to Strengthen Health Care” put forward by the Health Ministers in 2004, the Health Council of Canada concludes in their Progress Report 2012: Health care renewal in Canada that while much progress was made, important opportunities were missed.  One of these they point out is the ongoing lack of nationally shared health system performance goals accompanied by a set of comparable metrics by which we hold ourselves accountable to the public for progress.

Indeed, in another of their reports,  Measuring and reporting on health system performance in Canada: Opportunities for improvement, released in May 2012, the Council  points out the virtual impossibility of their assigned task of monitoring and reporting on the provinces’ progress on agreed goals of the 2004 Federal/Provincial/Territorial Health Accord, given the largely inadequate and somewhat “chaotic” state of measurement of health and health care across Canada.

Not that there isn’t quite a bit of good measurement and reporting on health and health care quality and performance happening. It’s mainly that these efforts are being carried out by a variety of national, provincial and regional organizations in a largely uncoordinated manner.  Due to this lack of coordination, Canadians are not realizing maximal benefit from all the intelligent, detailed and costly work being done across this country to create metrics and report on health system performance.  I fear thus far our cumulative efforts may be generating more heat than light.

To realize the goals of all this measurement work – namely to stimulate and support health care improvement and contribute to public accountability, we will need more than carefully crafted, comparable indicators reported at facility, regional and provincial levels by means of user-friendly, media attention-grabbing public reporting.  While these have some effect, they also can divert attention and resources from development and support of more localized measurement for improvement.

Like politics – all health care is local.  Improvement happens at the interface of patients and the people serving them or it doesn’t happen at all. Thus far, we have collectively relied too much on a “top down” approach – hoping that by highlighting performance or quality gaps at a population level we can motivate and inform improvements to care processes and outcomes. Unfortunately, presenting data on outcomes of care processes in the absence of sufficient information about the underlying processes does not help those responsible for the performance to respond in highly productive ways.

In future, much more attention needs to be paid to providing the support that very localized care delivery teams (including both clinical and administrative functions) need to enable them to identify their performance gaps and measure progress as they focus on specific improvement aims.  Not all measurement at this local level need be highly standardized or comparable (though some should be) – mostly it has to be very timely (daily), highly visible, and meaningful to the people trying to make improvements.  Importantly – where local improvement work needs to be linked to regional, provincial or national improvement aims – a connection, via logical or arithmetical measurement cascades, needs to be made between local and higher-level measurement.

So, Canada – let’s certainly continue to invest in the development of indicators that are comparable across the country.  These are important to understanding disparities in health and care and can play a role in improvement.  However – let’s commit to working harder to coordinate the work of various agencies that measure and build capacity to measure health care performance, to avoid creating duplications and distractions. Instead let’s have national, provincial and regional players work together to build stronger measurement connections between local care processes and wider health system improvement ambitions.

Comparable Indicators – A powerful tool to drive change

Dr. Ben Chan is President and CEO of Health Quality Ontario.

The Health Council of Canada's 2012 Progress Report describes numerous advances over the last decade in public reporting, both at the provincial and pan-Canadian levels.  But are we maximizing our ability to compare health system performance across the country?   The answer, it appears, is no.  The Council’s  report notes, for example, that many jurisdictions feel the indicators agreed on through the First Ministers’ Accord aren’t sufficient for their own measurement and reporting needs.  Why, then, is it so difficult to create a robust set of meaningful indicators for cross-national comparisons?

One reason presented by the report is that provinces appear interested in creating measurement systems for their own needs.  There is certainly evidence of that in Ontario, where the province has invested heavily in reporting on surgical wait times, hospital acquired infections and other patient safety measures.  For most of these measures, there are no equivalents elsewhere in the country.  Provinces with a firm agenda for quality cannot afford to wait for national consensus on indicator definitions before pushing for improvement.

But does the “narrow provincial focus” argument really explain the aspirations of individual provinces?   Not quite.  Here in Ontario, one of the strongest messages I’ve been hearing from local CEOs is a huge interest in benchmarks.  This thirst for comparable data is in no small part due to the quality improvement plans legislated for hospitals under the Excellent Care for All Act, 2010 (ECFAA).   Hospitals are required by law to set numeric targets for improvement for each fiscal year.  As a result, hospitals are looking for guidance as to what their evidence-based targets should be, and want to incorporate the strategies employed by high performers elsewhere.   This demand will only grow as the requirements of the ECFAA are spread to other parts of the health system, suc h as primary care.

The thirst for comparisons goes further.  Already, in our annual Quality Monitor report, we ask tough questions as to why we’re not matching the best results achieved elsewhere, in areas where good interprovincial comparisons exist.  Why, for example, does Colchester-Hants, Nova Scotia have a flu vaccination rate of 82%, when Ontario’s average is 68%? What are they doing that we’re not, but should be?  We’re also asking ourselves why the overall rate of hospitalization for ambulatory-sensitive conditions is 275 per 100,000 in Ontario, compared to a mere 162 in Richmond, B.C.

To achieve robust pan-Canadian reporting, we can build on our current successes in creating nationally standardized data sets and surveys. CIHI and Statistics Canada have made huge contributions to the country by making data sets like the Discharge Abstract Database and Canadian Community Health Survey available.   Some obvious next steps could be common definitions for reporting on wait times, and a minimum core set of standardized patient experience questions for primary, acute, long-term and community-based care.

Electronic medical records (EMRs) also represent a treasure trove of information on what should be one of our top priorities: providing better chronic disease management (CDM).  EMRs are proliferating across the country, and many EMR vendors operate now in multiple provinces.  Health Quality Ontario is currently advocating for more stringent EMR vendor specifications in order to ensure that standardized data on CDM is collected.  Our close partnership with CIHI can help ensure that these standards contribute to national standards.
 
All of us want to improve and to be among the top performers, but the only way we can truly know how we are performing is through comparison, to ourselves and to others. What we need now is a paradigm shift that recognizes that nationally standardized data sharing is one of our most powerful tools to drive change.  Indeed, it is in the self-interest of each province to do whatever we can to advance sharing of comparable indicators.

Comparable Indicators – a focus for conversation on better health care

Hugh B. MacLeod is CEO of the Canadian Patient Safety Institute. His interests lie in the areas of system/integrative thinking, sustainability, and organizational cultures that create high performance.

Redesigning a healthcare system with its complex organic properties, powerful interest groups, and its political game is much more challenging than the transformation of the auto sector, housing sector and the financial sector combined. Add to this a landscape of multiple players promoting numerous indicators which compete and confuse the system, rather than help us to learn and improve.

The recent global financial meltdown has raised new conversations in corporate board rooms about return on investments, outcomes not outputs, consumerism, ethics, codes of conduct, public transparency, baseline measurements, quality improvement, risk management, third party validation, rewards and consequences, etc.

The focus in healthcare should be on common areas of real value creation, such as: transparency, reduction of variation, greater coordination across the continuum of care, use of evidence, and obligations of citizens themselves not to abuse the system.. Public reporting with a focused set of comparable indicators will raise necessary conversations and important questions.  Are we using our money wisely?  What are the health outcomes for the investments?  Why do we have such a variance in care, spending and outcomes performance by province, by geographic area? Policy-makers and funders need to ensure the assumptions underlying their long-term healthcare plans reflect both the real economics of the market and the healthcare performance outcomes of the provider organizations.

Canadians deserve a responsive and responsible health system – that is, a healthcare system that evaluates progress; measures quality, performance or the patient experience; and shares learning.

It is important to acknowledge the role that partnerships of many national and jurisdictional organizations play in the quest for a safer healthcare system. Accreditation Canada, the Institute for Safe Medication Practices, the Canadian Institute for Health Information, Canada Health Infoway, the Canadian Agency for Drugs and Technologies in Health, provincial health quality councils, the Health Council of Canada and others are dedicated to helping organizations and peers improve the safety of healthcare.  Such partnerships foster a coordinated effort that minimizes duplication and promotes the very best in patient safety.

Through collaborative relationships, the implementation of key initiatives is enhanced, ensuring that patients see results sooner rather than later. 

Conference Board of Canada report echoes Health Council findings on home care

In our recently released report, Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada, we found that many seniors with complex needs are not getting the level of care they require and many of their family caregivers are becoming distressed. 

The Conference Board of Canada’s new report, Home and community care in Canada: An economic footprint estimates the economic impact of home and community care in Canada. The report highlights the implications for businesses of their employees doubling as family caregivers, and the potential spending implications of shifting care from institutions to homes. The report estimates that the total spending on home and community care in 2010 ranged from $8.9 billion to $10.5 billion, accounting for approximately 5% of total health spending in Canada. About 3 million Canadians are estimated to have given some level of unpaid care in 2007, providing over 1.5 billion hours of home support and community care.

Research into the cost-effectiveness of integrated home care programs would facilitate policy development and improvement of care for seniors, as there is a lack of recent economic data in this area.

The Conference Board of Canada has provided some important information for governments, policy makers, and the public in terms of the financial implications of an aging population that wants to be cared for at home. The Conference Board echoes our finding that family caregivers provide the highest proportion of care, but that distressed family caregivers may have additional economic implications.

Canadian governments are recognizing that an aging population along with rising health care costs requires a greater focus on home and community care. We have profiled some innovative practices in our report that are examples of effective home care policies and programs. We encourage others to adapt and expand what’s already working to ensure that seniors and their family caregivers can live healthy and comfortable lives at home.

By: Shilpi Majumder, Policy Lead, Health Council of Canada