Utilization and Cost of Home Care in Breast Cancer

As the pressure to reduce the length of hospital stays increases, use of home care services is increasing1. As a result of health care reforms in the province of Ontario beginning in the mid-1990s, the setting for some health care services has shifted from the hospital to the home. Benefits of a home care system include reduced pressure on acute care facilities through expeditious discharge of patients to a setting that would allow for patients to be managed at their residence; convenience for patients; and bridging care between acute care facilities, rehabilitation programs, and long-term care facilities. Despite attempts in various health care systems to replace hospitals with services delivered to patients in the home2, only a handful of population-based studies have examined home care utilization and its associated costs3–6. In Ontario, a province with a population of 13.2 million7, home care services for permanent residents are provided through the publicly funded health care system. The provincial government (Ontario Ministry of Health and Long-Term Care through Community Care Access Centres) reimburses some home care services such as nursing care, personal support, and respite care. For each service delivered, a record of the type and cost of the service is captured in a provincial database linkable to other administrative data including the Ontario Cancer Registry. This population-level data provides researchers with a unique opportunity to explore utilization patterns and costs of home care services delivered to various populations—for example, women diagnosed with breast cancer (bc). ABSTRACT