Poster Presentations

P-7: Spending wisely: Home Care Assessment Cost in Ontario

Sophie Hogeveen*, Chi-Ling Joanna Sinn*, John Hirdes

University of Waterloo

Objectives: With an aging population and increased focus on home and community care, questions are raised about how best to allocate limited resources. The objective is to estimate the time and money allocated to assessment in home care relative to the amount spent on service provision. 

Methods: In Ontario, all long-stay home care clients are assessed using the RAI-Home Care (RAI-HC). The results inform the type and frequency of services in the care plan. RAI-HCs completed in fiscal years 2012/2013 and 2013/2014 were linked to a billed services record (N=288,278). Hours or number of visits for nursing, personal support, physiotherapy and eight other disciplines were aggregated from the assessment date until the next assessment or discharge. Service volumes were multiplied by region-specific costs for providing each service. 

Results: The sum of hours of assessment was divided by the sum of hours of care (assessment and services) provided. Cost was calculated in the same way. Only 1.41% of total hours or 1.56% of total cost of care was spent on assessment. In other words, less than 2% of time and money spent on home care clients was devoted to their assessment with the RAI-HC. Results were consistent across type of assessment and region. 

Conclusions: Assessment time and cost account for a small proportion of total resources spent in home care. Eliminating duplication of assessments and improving sharing of information throughout the health care system can further make the assessment process more efficient.