title: The possibilities and the realities of home care.
abstract: BACKGROUND
  An analysis of a provincial home care dataset, comparing home care client, service, and providers in 1991/92 through 2000/01, was undertaken to describe changes over the decade, and permit a more informed discussion of home care in relation to Canadian health policy developments and health system reforms.
  
  
  METHODS
  After data were obtained upon request from Alberta's Ministry of Health and Wellness, descriptive and comparative statistical analyses were undertaken using the SPSS computer program. Logistic regression was used to compare multiple client characteristics in the first and last years.
  
  
  RESULTS
  Home care clients doubled and the mean hours of care per client increased substantially, although the duration of care provision declined. The mean age of clients also declined. Home care continued to be primarily provided by Home Support Aides, with self-managed care increasing dramatically. Sustained geographical differences in home care were noted.
  
  
  CONCLUSIONS
  Although home care has much potential for enabling early discharge from hospital, and for maintaining or improving health, few population-level studies of home care trends exist. In Alberta, although formal home care hours increased, home care expansion was not uniform across the province. Home Support Aides continued to be the primary care provider. In the face of substantial hospital downsizing, these observations could imply that the provision of home care has been off loaded to families. Moreover, home care increases do not appear to be related to an aging population.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, AB. donna.wilson@ualberta.ca
authors.forename: Donna
authors.initials: D
authors.lastname: Wilson
authors.forename: Corrine D
authors.initials: CD
authors.lastname: Truman
authors.forename: Joe
authors.initials: J
authors.lastname: Huang
authors.forename: Sam
authors.initials: S
authors.lastname: Sheps
authors.forename: Roger
authors.initials: R
authors.lastname: Thomas
authors.forename: Tom
authors.initials: T
authors.lastname: Noseworthy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D019992:Databases as Topic; D005260:Female; D018166:Health Care Reform; D006285:Health Planning; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D014600:Utilization Review