"My home is not my home anymore:" Improving Continuity of Care in Home Care

The management of homecare services changed following the 1995 election of a new provincial government in Ontario. Forty-three not-for-profit transfer agencies called Community Care Access Centres(CCACs) were created to manage homecare and act as purchasers of services for homecare clients. CCACs were directed by volunteer community boards overseeing the introduction of competitive contracting for homecare service provision. At the same time, hospital downsizing led to patients being discharged sooner, sicker, and more likely to need homecare during their recovery at home. In this environment, we examined what continuity in homecare means for different stakeholders, including longer-term clients, case managers, service providers, and community physicians. We also examined the problems with care continuity that clients experienced, the implementation of the competitive contracting model, and the impact of competitive contracting on continuity of care and the consistency of homecare personnel for clients in one Ontario community.

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