HOME CARE UTILIZATION PATTERNS AMONG THE ELDERLY POPULATION:a Case Study of Ontario, Canada
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The demand for home care increased dramatically in Canada in the past decade. This was because more patients were discharged from hospital, more emphasis was put on health care at the home and community levels, the continuing aging of the population, advancements in technology, and the adoption of a more cost-effective strategies. Though home care is still not a part of Canadian Health Act (CHA) and there are no national regulations for home care, people value the significance of home care. Home care is now one of the fastest growing sectors in Canada’s health care system. With a focus on the elderly population in the province of Ontario, this thesis uses data from the Canadian Community Health Survey (CCHS cycle 1.1, 2.1 and 3.1) to examine utilization patterns of home care considering social and geographical factors, the variation within home care service provision, and unmet home care need. The major findings of the thesis are that seniors with poorer health status, older age, female, with lower household incomes, marital status widowed/separated/divorced/single/never married, and living in urban areas are more likely to use home care. At the same time, seniors who are older, with poorer health status, and suffering from chronic condition are in a more vulnerable position to receive the home care they need. A large amount of responsibility was shifted to informal caregivers due to the budget constraints and the policy bias of the government. Access to home care is unequal on a geographical scale. Seniors living in rural and remote areas tend to have more unmet home care needs than seniors living in urban areas. People living in rural northern regions in Ontario have the least access to home care. Also, seniors living in urban areas have a greater chance of getting government provided care than those living in rural areas. Overall, under the current managed competition model of home care in Ontario, unequal accessibility, insufficient services, an excessive burden on informal caregivers are observed.