Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

National home care standards urged

Roger Collier
CMAJ February 08, 2011 183 (2) 176-177; DOI: https://doi.org/10.1503/cmaj.109-3731
Roger Collier
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Home care has become one of the fastest-growing areas in Canadian health care over the past decade, though, as is often the case in Canada’s fractured health care landscape, some provinces are performing better than others.

It is difficult, however, to compare the state of home care in different jurisdictions because the very notion of home care differs from province to province. This is why, according to Marg McAlister, a project manager for the Canadian Home Care Association, Canada needs a set of national standards for home care.

“It is hard to compare province to province because each defines the roles of various professions in home care differently,” says McAlister.

The most comprehensive look at home care across Canada can be found in the Canadian Home Care Association’s Portraits of Home Care in Canada 2008 (www.cdnhomecare.ca/media.php?mid=1877), an update of a 2003 report that gave home care leaders the opportunity to “have their voices heard through their descriptions of home care as it is known and understood within each of their respective jurisdictions.” Though the document warns that “valid comparisons cannot be made because of the absence of data definitions and the variation of data collection and reporting across Canada,” it does offer “snapshots” of home care programs, which highlight such features as governance, organization, services, quality and accountability (Table 1).

View this table:
  • View inline
  • View popup
  • Download powerpoint
Table 1:

Home care across Canada

Figure1

There is a significant nation-wide variation in the maximum number of hours per week of home care services that people are entitled to access.

Image courtesy of © 2011 Jupiterimages Corp.

With respect to governance, there is little variation across the country, with 12 of 13 provinces and territories operating home care services under the jurisdiction of their ministries of health. The lone exception is New Brunswick, where home care is run by the New Brunswick Department of Health and Wellness and the New Brunswick Department of Social Development.

Legislation for home care, on the other hand, varies widely — tucked into various acts, orders-in-council, guidelines and policies. “This lack of a specific legislative framework for home care contributes to the wide variation in access and availability of services across Canada,” the report states.

In terms of services, almost all jurisdictions offer core services such as case management and home care nursing. There are many other services, however, and some are offered in certain places but not others. For instance, speech language therapy is available in Alberta and Ontario, but is not available in Saskatchewan or Manitoba. Social work is part of home care in British Columbia and Alberta. It is not part of home care in Nova Scotia and Saskatchewan.

“Services such as nursing and personal support in the home, they would be offered in every province across every province,” says Margaret MacAdam, president of Age Advantage, a Toronto, Ontario-based company that offers gerontological consultation and strategic planning. “Beyond that, they offer a range of home care services.”

Again, it is difficult to do a detailed provincial comparison because jurisdictions have different names and definitions for the services they offer. In some places, for example, bathing and grooming assistance may fall under home support services, whereas in other places it may fall under adult day services. What is clear, though, is that Canadians have access to a wide selection of services, though that access is far from equal.

“Home care polices, services and their delivery vary greatly across the country, as each home care program evolved in response to the needs of their community and existing resources,” the report states. “An example of this variation is in the availability of supportive services for individuals with long-term chronic conditions which may include home support, homemaking and options for assisted living facilities.”

There is also a variation across Canada in fee structure. According to the 2008 report, four provinces do not charge direct fees for home care services: Ontario, Manitoba, Quebec and Prince Edward Island. (Canada’s three territories don’t charge fees, either.) The fees in the remaining six provinces are based on people’s incomes, and generally apply to long-term supports and residential care. In British Columbia, the maximum amount of fees that can be charged is $300 per month, the same as in Alberta. In Saskatchewan, the ceiling is higher, at $421 per month.

Another variable between jurisdictions is the maximum number of hours per week that, under normal circumstances, people are entitled to access home care services. In Quebec, for instance, the average upper limit is 35–40 hours per week, whereas in Prince Edward Island, the weekly maximum is 28 hours. British Columbia has a working guideline of 30 hours per week, and in Ontario, people can receive up to 80 hours in their first month of home care, that limit dropping to 60 hours for each additional month. (All figures from Health Canada: www.hc-sc.gc.ca/hcs-sss/pubs/home-domicile/1999-pt-synthes/section_4-eng.php).

The Canadian Home Care Association’s report also contains a metric called “hospitalization rates for ambulatory care sensitive conditions,” which they define as hospitalization rates for conditions that could be provided in the community, and which serve as an indicator of appropriate access to community-based care. This national average of this rate in 2005–2006 was 389 admissions per 100 000 people. British Columbia had the lowest rate (320) and Nunavut had the highest (1104).

When it comes to funding, most jurisdictions spend somewhere in the neighbourhood of $120 per capita, though some exceed that amount (Newfoundland and Labrador: $190; New Brunswick: $177.13) and some fall below (Saskatchewan: $110; Northwest Territories: $97.37). In terms of percentage of health funding dedicated to home care, Alberta (7.36%) and Manitoba (6.7%) are among the leaders, while Prince Edward Island (2.28%) and the NWT (1.49%) are among those pulling up the rear.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 183 (2)
CMAJ
Vol. 183, Issue 2
8 Feb 2011
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
National home care standards urged
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
National home care standards urged
Roger Collier
CMAJ Feb 2011, 183 (2) 176-177; DOI: 10.1503/cmaj.109-3731

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
National home care standards urged
Roger Collier
CMAJ Feb 2011, 183 (2) 176-177; DOI: 10.1503/cmaj.109-3731
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Feds update immunization advice with Moderna vaccine approval
  • Canada will have three-digit suicide prevention hotline by 2023
  • Trudeau promises to boost federal health transfers when the pandemic is over
Show more News

Similar Articles

Collections

  • Topics
    • Palliative medicine
    • Aboriginal health

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire