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Facts & Figures - Publicly Funded Home Care

Note:  All Community Care Access Centres (CCACs) transitioned into the Local Health Integration Networks (LHINs) as of June 2017.

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).
  • Up until June 2017, fourteen Community Care Access Centres (CCACs) were accountable to the LHINs and provided access to government funded home and community services and long-term care homes. 
  • As of June 2017, the LHINs are the providers of government funded home and community services and long-term care homes.

Facts & Figures for Community Care Access Centres (CCACs)

In 2015-16:

  • CCACs employed 6,825 FTEs.1
  • 729,357 clients received services funded by the CCACs.2  (Note, a client who is transferred or re-admitted may be counted more than once)
  • 39,318,763 visits/hours of care were delivered3
    • 74% of care delivered was personal support / homemaking
    • 21.5% of service was nursing (shift and visits)
    • 4.5% 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 2015/16 
Individuals Served: 603,535 616,952 637,727 653,730  699,020 713,493  729,357 
Client Age: Age 65+ 54% 56% 56% 58%  58%  62% 63% 
Client Age: Age 19-64 30% 28% 28% 27%  32% 23%  23% 
Client Age: Age 0-18 16% 16% 16% 15%  10% 14%  14% 
Clients Placed in Long-Term Care Homes: 26,367 25,761 26,589 25,890 26,374  27,648 28,426 
Full-Time Employees (approx.): 5,603 5,701 6,052 6,220  6,627 6,684  6,825 
Services    
Total Units 29,419,559 29,821,293 32,806,689 34,473,802 37,991,053 38,687,656  39,318,763 
Personal Support/Homemaking Hours: 20,358,189 20,965,448 23,349,790 24,926,360 27,719,897 28,529,882  29,113,765 
Total Nursing 7,697,234 7,606,320  8,149,821  8,241,067   7,980,381 8,344,089  8,450,716 
Nursing Visits: 5,962,097 5,799,127 6,172,865 6,135,730  5,713,359 5,932,298  6,018,931 
Shift Nursing Hours: 1,735,137 1,807,193 1,976,956 2,105,337 2,267,022 2,411,791  2,431,931 
Total Rehabilitation 1,364,096  1,249,525  1,307,078  1,306,375  1,623,478  1,782,933  1,754,282 
Occupational Therapy Visits: 506,154 482,051 513,290 521,497 553,209 414,416  572,215 
Physiotherapy Visits: 483,163 426,690 444,054 435,521 705,052 778,482  807,187 
Speech-Language Therapy Visits: 251,740 242,998 245,782 250,147 263,571 59,247  270,785 
Dietician Services Visits: 52,877 45,384 47,954 48,681 49,014 48,067  49,043 
Social Work Visits: 70,202 52,402 55,998 50,529 52,542 54,519  55,052 

 

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
  •  In 2015/16, approximately 60% of referrals to publicly funded home care came from the hospital, 33% from the community, and 7% from schools.
  • On March 31, 2016, there were 609 patients specifically designated to go home and yet waiting (ALC) to be discharged home with publicly funded home care service on March 31, 2016.

Government Expenditures on Home Care

  • Between 2005/06 and 2015/16, 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?

  • 11.6% of new home care patients discharged from the hospital experienced an unplanned return to hospital within 30 days after being discharged in 2014-15 - down from 12.9% in 2006-07.11
  • 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

Some clinical issues of patients receiving publicly funded home care

  • 27.7% of home care patients reported that they did not receive an influenza vaccine in the preceding two years in 2015-16 - up from 24.2% in 2010-11.13
  • 59.9% of Ontario patients receiving publicly funded home care for at least 60 days developed a new problem with incontinence that did not improve, or had worsened bladder function since their previous assessment in 2015-16 - up from 52.3% in 2010-11.

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

  • 91.8% of home care patients were satisfied with their care from both care coordinators and service providers in 2015-16.14
  • Investing in home-based care can save money, improve care and improve quality of life for people who would otherwise be hospitalized or institutionalized.
  • 17% of all people who were admitted to a long-term care home were assessed as having low, mild or moderate needs in 2015-16.

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.15
  • 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.16

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. Health Quality Ontario. Home Care Reporting – Provincial Results Summary by Attribute and Indicator, 2014/15.Retrieved from http://www.hqontario.ca/System-Performance/Home-Care-Performance/Patient-Experience
15. 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
16. Ibid

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