This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Coyte, P. C.
Right arrow Articles by Young, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Coyte, P. C.
Right arrow Articles by Young, W.
Related Collections
Right arrow Health services research
Right arrow Canadian government
Right arrow Other medicare
CMAJ • August 24, 1999; 161 (4)
© 1999 Canadian Medical Association or its licensors

Evidence
Études

Regional variations in the use of home care services in Ontario, 1993/95

Peter C. Coyte, MA, PhD and Wendy Young, MA

From (Coyte) the Department of Health Administration, (Coyte) the Home Care Evaluation and Research Centre, (Coyte, Young) the Institute for Clinical Evaluative Sciences, (Coyte) the Institute for Policy Analysis and (Coyte) the Hospital Management Research Unit, University of Toronto, Toronto, Ont., and (Coyte) the Arthritis Community Research and Evaluation Unit, the Wellesley Hospital Research Institute, Toronto, Ont.

Abstract

Background: Although regional variations in the use of many health care services have been reported, little attention has been devoted to home care practices. Given the dramatic shift in care settings from hospitals to private homes, it is important to determine the extent to which home care practices vary by geographic region.

Methods: Data from the Canadian Institute for Health Information and the Ontario Home Care Administration System database were used to assess regional variations in rates of home care use following inpatient care and same-day surgery for the fiscal years 1993, 1994 and 1995. Various measures of regional variation were employed.

Results: Of the 2 870 695 inpatient separations and 1 803 307 same-day surgery separations during the study period, 359 972 and 64 541, respectively, were followed by home care. The rate of home care use per 100 separations was 12.5 for inpatients and 3.6 for same-day surgery patients. There was a a 3.5-fold regional variation in the rates of home care use following inpatient care and a 7-fold variation in rates of use following same-day surgery. Additional home care funding to attain calculated target rates was estimated to be $48.9 million (30% of expenditures for patients recently discharged from hospital over the study period). For a 20% increase in service provision it was estimated that an additional injection of $42.2 million is required.

Interpretation: The wide regional variations in rates of home care use highlight the importance of modifying home care funding to ensure that all residents of Ontario have equal access to services. To achieve this our estimates suggest that a substantial increase in home care funding is warranted.




This article has been cited by other articles:


Home page
 AJPHHome page
H. Hoenig, D. H. Taylor Jr, and F. A. Sloan
Does Assistive Technology Substitute for Personal Assistance Among the Disabled Elderly?
Am J Public Health, February 1, 2003; 93(2): 330 - 337.
[Abstract] [Full Text] [PDF]