The Gerontologist
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Penning, M. J.
Right arrow Articles by Allan, D. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Penning, M. J.
Right arrow Articles by Allan, D. E.
The Gerontologist 46:744-758 (2006)
© 2006 The Gerontological Society of America

Home Care and Health Reform: Changes in Home Care Utilization in One Canadian Province, 1990–2000

Margaret J. Penning, PhD1, Moyra E. Brackley, PhD2 and Diane E. Allan, MA3

Correspondence: Address correspondence to Margaret J. Penning, PhD, Department of Sociology and Centre on Aging, University of Victoria, PO Box 1700, STN CSC Victoria, British Columbia, Canada V8W 2Y2. E-mail: mpenning{at}uvic.ca

Purpose: This study examines population-based trends in home care service utilization, alone and in conjunction with hospitalizations, during a period of health reform in Canada. It focuses on the extent to which observed trends suggest enhanced community-based care relative to three competing hypotheses: cost-cutting, medicalization, and profitization. Design and Methods: Analyses drew on administrative health data from the province of British Columbia for the period from 1990 through 2000. Annual trends in age- and gender-adjusted utilization rates are examined by use of joinpoint regression; multivariate analyses draw on generalized linear modeling. Results:Home support claims decreased significantly during the study period. There was less evidence of decline with regard to home nursing care claims and the extent of both home support and home nursing care. Intensity of care increased for home support services but decreased somewhat for home nursing care. Multivariate analyses revealed a decline in joint use of home support and hospital care and little change in joint use of home nursing and hospital care. Similarities as well as differences in trends are evident across age groups. Implications: The findings suggest a reduction and reallocation of health services in general rather than a shift of focus toward community-based care. In this way, they appear more consistent with a cost-reduction hypothesis than with expectations of enhanced community-based care that are generated by recent health reform initiatives.

Key Words: Health reform • Health service utilization • Home care







HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.