title: Home care in Canada: passing the buck.
abstract: This paper provides an overview of Canadian home-care utilization, highlights the health-policy assumptions that have resulted in an increasing reliance on in-home services, and assesses the current roles of the private and public sectors in the financing of home care. Significant interprovincial variations in per capita home-care expenditures and potential inequalities in access to home care call for resolution by federal and provincial governments. There is a need for consensus with respect to medically and socially necessary services that are subject to national standards, irrespective of the setting in which services are sought, received, and delivered. The development and enforcement of national home-care standards that complement the principles of the Canada Health Act would be a useful first step in ensuring that the Canadian health-care system is ready to confront the challenges of the new millennium.
authors.affiliation: Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. peter.coyte@utoronto.ca
authors.forename: P C
authors.initials: PC
authors.lastname: Coyte
authors.forename: P
authors.initials: P
authors.lastname: McKeever
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002648:Child; D002675:Child, Preschool; D005260:Female; D005380:Financing, Government / Q000458:organization & administration; D005544:Forecasting; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends; D006291:Health Policy / Q000191:economics / Q000639:trends; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D020380:Needs Assessment; D011057:Politics; D017410:Practice Guidelines as Topic; D017149:Private Sector / Q000458:organization & administration; D017678:Sex Distribution