Who ’ s next ? Referral prioritisation criteria for home care occupational therapy

Background/aims: Prioritising referrals on waiting lists is common practice in rehabilitation. However, little is known about the exact criteria that are used in home-based occupational therapy to determine the level of urgency. This study aimed to identify prioritisation criteria in home-based occupational therapy services in Quebec, Canada and to describe how they are used in practice. Methods: A mail and telephone survey of 55 home care programmes across Quebec was conducted. Participants provided information about occupational therapy wait times and referral prioritisation tools and practices. A detailed quantitative content analysis compared the content of all referral prioritisation tools. Results: This study identified 48 main categories of referral prioritisation criteria, but only nine of them were present in the majority of tools. Wait times vary greatly between priority levels, with a median of 2 days for urgent referrals and 20 months for low priority referrals. In general, problems related to safety and remaining at home are considered more urgent than problems related to independence, quality of life, and activities outside the home. Conclusions: These findings highlight the need for more consistent and evidence-based prioritisation criteria for occupational therapy in home care in order to facilitate equitable access to these services.