Facts & Figures - Publicly Funded Home Care

Who can receive home care in Ontario?

  • Any Ontarian that meets the eligibility criteria for publicly funded home care can receive the service.

Who oversees publicly funded home care?

  • In Ontario, publicly funded home care falls under the jurisdiction of the MOHLTC, which provides stewardship of the health system. Local health services are planned and funded by Local Health Integration Networks (LHINs).
  • Fourteen Community Care Access Centres (CCACs) are accountable to the LHINs and provide access to government funded home and community services and long-term care homes.

Facts & Figures for Community Care Access Centres (CCACs)

In 2014-15:

  • CCACs employed approximately 6,775 staff; 5,100 worked as care coordinators and team assistants.1
  • 713,493 clients received home care services funded by the CCACs.2  (Note, a client who is transferred or re-admitted may be counted more than once)
  • 38,687,656 visits/hours of care were delivered3
    • 74% of care delivered was personal support / homemaking
    • 22% of service was nursing (shift and visits)
    • 4.6% of visits/hours were provided by therapy providers
      • Occupational Therapy – 1.5%
      • Physiotherapy – 2.1%
      • Speech – 0.7%
      • Social Work – 0.17%
      • Dietician Services – 0.13%

Trends in CCAC services:

Apr 1 to Mar 314 2009/10 2010/11 2011/12 2012/13  2013/14  2014/15
Individuals Served: 603,535 616,952 637,727 653,730  699,020 713,493 
Client Age: Age 65+ 54% 56% 56% 58%  58%  
Client Age: Age 19-64 30% 28% 28% 27%  32%  
Client Age: Age 0-18 16% 16% 16% 15%  10%  
Clients Placed in Long-Term Care Homes: 26,367 25,761 26,589 25,890 26,374  ~27,000 
Full-Time Employees (approx.): 5,603 5,701 6,052 6,220  6,627 6,684 
Services  
Total Units 29,419,559 29,821,293 32,806,689 34,473,802 37,991,053 38,687,656 
Personal Support/Homemaking Hours: 20,358,189 20,965,448 23,349,790 24,926,360 27,719,897 28,529,882 
Total Nursing 7,697,234 7,606,320  8,149,821  8,241,067   7,980,381 8,344,089 
Nursing Visits: 5,962,097 5,799,127 6,172,865 6,135,730  5,713,359 5,932,298 
Shift Nursing Hours: 1,735,137 1,807,193 1,976,956 2,105,337 2,267,022 2,411,791 
Total Rehabilitation 1,364,096  1,249,525  1,307,078  1,306,375  1,623,478  1,782,933 
Occupational Therapy Visits: 506,154 482,051 513,290 521,497 553,209 414,416 
Physiotherapy Visits: 483,163 426,690 444,054 435,521 705,052 778,482 
Speech-Language Therapy Visits: 251,740 242,998 245,782 250,147 263,571 59,247 
Dietician Services Visits: 52,877 45,384 47,954 48,681 49,014 48,067 
Social Work Visits: 70,202 52,402 55,998 50,529 52,542 54,519 

 

CCAC Client Population

  • In 2014/15, approximately 70% of CCAC long-stay patients were categorized as complex, compared to less than 40% only  five years ago.5
  • 96,000 children received health services at school.​6

Government Expenditures on Home Care

  • Between 2005/06 and 2014/15, overall CCAC funding (which includes funding for home care and other CCAC services, such as long-term-care home placement) has increased by 73% from $1.4 billion to $2.5 billion, but has remained a relatively constant 4% to 5% of overall provincial health spending.7
  • Costs for CCAC services ranged  between $2,892 and $3,775 per person; the average was about $3,400 per person.8

Do Ontarians receive palliative care at home?

  • Although cancer patients represent only 30% of Canadian deaths annually, they make up 80% of end-of-life clients for the CCACs and occupy approximately 85% of hospice beds.9
  • 10% of all ALC days in Ontario in the 2013/14 fiscal year were due to patients waiting in hospital for palliative care elsewhere.10

How likely is a return to hospital for home care clients who have recently been discharged?

  • 12% of new home care clients discharged from the hospital experienced an unplanned return to hospital within 30 days after being discharged in 2013-14.11
  • 26% of individuals had an unscheduled emergency department visit within 30 days after being discharged from the hospital and referred for home care services  in 2013-14.12
  • 27% of home care clients reported that they did not receive an influenza vaccine in the preceding two years  in 2013-14.13

Do home care clients receive a positive experience from home care services?

  • Nine out of ten home care clients have a positive experience with nursing, personal support, physiotherapy, occupational therapy, speech and language therapy, and nutrition and social work services arranged by CCACs.
  • Investing in home-based care can save money, improve care and improve quality of life for people who would otherwise be hospitalized or institutionalized.

What is the average cost of care in Ontario?

Average Cost of Care
(for one week for 424 seniors)
Hospital Bed $2.5 million
Long-term Care Bed $374,000.00
Care at Home $125,000.00
Average Per Diem Cost
Hospital Bed $842.00/day
Long-Term Care Bed $126.00/day
Care at Home $42.00/day

(2011) HOME First Shifts care of Seniors to HOME. LHINfo Minute, Northeastern Ontario Health Care Update

  • Caring for terminally ill patients in an acute-care hospital is estimated to cost over 40% more than providing care in a hospital-based palliative-care unit, more than double the cost of providing care in a hospice bed, and over 10 times more than providing at-home care.14
  • The cost of providing palliative care in the last month of a patient’s life averages about:
    • $1,100 per day in an acute-care hospital bed
    • $630 to $770 per day in a bed in a palliative-care unit 
    • $460 per day in a hospice bed
    • under $100 per day where at-home care is provided.15

References

1.  Auditor General of Ontario (2015). 2015 Annual Report of the Office of the Auditor General of Ontario. Chapter 3.01, CCACs-Community Care Access Centres-Home Care. http://www.auditor.on.ca/en/reports_en/en15/3.01en15.pdf
2. Ibid
3. Ibid
4. Various sources including OACCAC, MOHLTC, Ontario Ministry of Finance
5. Auditor General of Ontario (2015). 2015 Annual Report of the Office of the Auditor General of Ontario. Chapter 3.01, CCACs-Community Care Access Centres-Home Care. http://www.auditor.on.ca/en/reports_en/en15/3.01en15.pdf
6. OACCAC.  CCAC Fast Facts 2015. Retrieved from http://oaccac.com/News/Pages/CCACs-by-the-numbers-infographic.aspx
7. Auditor General of Ontario (2015). 2015 Annual Report of the Office of the Auditor General of Ontario. Chapter 3.01, CCACs-Community Care Access Centres-Home Care. http://www.auditor.on.ca/en/reports_en/en15/3.01en15.pdf
8. Ibid
9. Auditor General of Ontario (2014). 2014 Annual Report of the Office of the Auditor General of Ontario. Chapter 3.08, Palliative Care. http://www.auditor.on.ca/en/reports_en/en14/308en14.pdf
10. Ibid
11.  Health Quality Ontario. Home Care Reporting – Provincial Results Summary by Attribute and Indicator, 2013/14. http://www.hqontario.ca/Public-Reporting/Home-Care
12. Ibid
13. Ibid
14. Auditor General of Ontario (2014). 2014 Annual Report of the Office of the Auditor General of Ontario. Chapter 3.08, Palliative Care. http://www.auditor.on.ca/en/reports_en/en14/308en14.pdf
15. Ibid

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