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ABSTRACT: The objective of the study was to determine the extent to which community care packages could be provided at a lower cost than facility-based long-term care (LTC) for 864 individuals on the LTC waiting list in urban and rural parts of Northwestern Ontario, Canada. A sequential mixed methods design was used entailing a retrospective chart review, the formation of case vignettes, the creation of community care packages with an 'expert panel' of care managers, the costing of care packages and the calculation of potential diversion rates from LTC. Data collection took place in Northwestern Ontario between the months of March and June 2008. Eight per cent of individuals in the urban area and 50% of individuals from the rural areas could potentially be safely diverted to the community and provided with a community care package at a cost lower than facility-based LTC. There is potential for home and community care to substitute for more costly long-term care, but doing so requires building capacity in this sector, particularly in rural areas, which are currently underserviced. Reconfiguring the 'balance of care' may lead to long-term cost efficiencies for an ageing population.
Health & Social Care in the Community 05/2012; 20(4):438-48. · 0.86 Impact Factor
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ABSTRACT: A group of student interviewers sat down with distinguished conference attendees at the 2008 Canadian Association for Health Services and Policy Research Conference. These leaders in the field shared a wealth of advice about career planning (don't), seizing opportunities (do) and connecting with colleagues and community (do often). We learned that a passion for lifelong learning, a willingness to get ordinary things done and a little luck go a long way towards career success.
Healthcare policy = Politiques de sante 08/2009; 5(1):e109-14.
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ABSTRACT: We are very grateful to the editors of HealthcarePapers for making this timely journal edition possible, and to our distinguished contributors for sharing their valuable insights on aging at home from local, national and international perspectives. While starting from different points and using different approaches, each contributor has articulated a common message: not only is it desirable to support the quality of life, independence and well-being of older persons and their caregivers in home and community, it is possible to do so while contributing to health system sustainability. If people are the top line of aging at home, cost-effectiveness and system sustainability are the bottom line.
HealthcarePapers 01/2009; 10(1):79-83.
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ABSTRACT: Integrating community-based health and social care has grabbed international attention as a way of addressing the needs of aging populations while contributing to health systems' sustainability. However, integrating initiatives in different jurisdictions work (or do not work) within very various institutional and structural dynamics. The question is, what transferable lessons can we learn to guide policy makers and policy innovators at the local level? In this paper, we consider "aging at home" as a policy option in Ontario, and beyond. In the first section, we focus on the problem, in effect, what not to do. Here, we briefly review findings from national and international research literature and from our own research in Ontario that identify the costs and consequences of non-systems of care for older persons. In the second part, we turn to solutions, in effect, what to do. Drawing on our recent scoping review of the international literature, we identify three guiding principles, as well as a number of recommendations, for integrating care for older persons, knowing that important details of how to put such initiatives "on the ground" will be provided by other contributors to this journal edition.
HealthcarePapers 01/2009; 10(1):8-21.
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ABSTRACT: Why can many older persons with relatively high needs age successfully at home, while others with similar needs require residential long-term care (LTC)? How can healthcare investments best be balanced to ensure that older persons have access to the most appropriate, cost-effective care?
Healthcare quarterly (Toronto, Ont.) 02/2008; 12(2):95-105.
