Home and Community Care Digest
Method: The Commission engaged in an extensive process of consultation with Canadians and commissioned a series of reports that formed the basis of its home care recommendations. Financing recommendations for 4 areas of home care were based on Canadian and international data.
Findings: The Commission argued that health care has evolved since the period when medicare was introduced. Health care today is associated with more than one privileged setting (hospitals) and one set of providers (physicians). Many health care services are now available to Canadians at home. Consequently, the Commission recommended revisions to the Canada Health Act to include home care as an entitlement.
The Commission recommended annual funding of almost $1 Billion
for 4 home care areas:
Home mental health: Based on a caseload of 57,137 and annual case costs of almost $10,000, yielding expenditures of $568.1 million pa;
Post-acute rehabilitation: Based on a caseload of seniors over 75 years of age (167,471) who are serviced for 28 days at the daily cost of $43.63, yielding $204.6 million pa;
Post-acute medical care: Based on a caseload of seniors over 65 years of age (267,953) who are serviced for 14 days at the daily cost of $31.39, yielding $117.8 million pa; and
Palliative care: Based on a caseload of 50,974 patients who are serviced for 30 days at a daily cost of $58.40, yielding $89.3 million pa. This caseload is derived from all cancer deaths, inflated by 20% to account for other eligible care recipients, and discounted by 33.3% to account for those who may not use such care.
Conclusions: Home care entitlement helps to modernize the Canada Health Act. However, if federal transfers for home care are insufficient, this entitlement will present a significant unfunded liability for provinces. The Romanow funding recommendations warrant further inquiry because: the caseloads appear to be underestimated; the servicing periods may be too short; and the estimated daily cost of appropriate care may be insufficient.
Reference:Building on Values: The Future of Health Care in Canada, 2002. (The Romanow Report.)
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