Grant: Fellowship - Priority Announcement: Aging

Background: The retirement home (RH) sector is essential in supporting aging in the right place but is often overlooked. Retirement home residents (RHR) have higher rates of emergency department (ED) visits, hospital admissions, and alternate level of care days compared to nursing home residents, yet a significantly lower rate of primary care visits. The interconnections between the RH and primary care sectors remain poorly understood contributing to a missed opportunity to positively impact the health and care experiences of RHR and support community-based care. Aims and Methods: This mixed methods, integrated knowledge translation study will develop policy recommendations for improving care integration for RHR, informed by the lived experiences of RHR, family carers, and care providers in Ontario. Aim 1: To describe the RHR experience seeking care across the RH, primary care, and acute care sectors by interviewing 5 RHR and 5 family carers to render a composite "essence" of their care experience. Aim 2: To characterize rates and predictors of acute and primary care use for RHR using the databases held at ICES (formerly the Institute for Clinical Evaluative Sciences) and describe clinical and demographic factors that increase hospitalization risk for RHR. Aim 3: To learn from the experiences of clinicians working with RHR by building a rich description of current ways of working across the primary care, acute care, and RH sectors in Ontario from key informant interviews with 5 primary care providers and 5 acute care providers in frequent contact with RHR. Significance: Dealing with strain on EDs and hospital beds is a high priority area. Primary care teams have a unique and important role to facilitate integrated care across sectors to improve patient experiences and outcomes for RHR and health system functioning. Project findings will be used to inform decision making at the Ministries of Health and Seniors and Accessibility, and in Ontario Health Teams.