Grant: Operating Grant: SPOR PIHCI Network - Comparative Prg. and Policy Analysis

Older people are the main users of publicly funded care continuums comprised of home care, various types of community-based housing with health services care options (called supportive housing in this research), and nursing homes. While this basic continuum exists across Canada, provinces vary greatly in terms of the number and type of services that they offer. This is especially the case in Manitoba and Alberta. Manitoba has the second largest supply of nursing home beds in Canada but has one type of supportive housing. Alberta has the smallest supply of nursing home beds in Canada with four levels of supportive housing. No research examines how these different continuums work. We don't know (for example) how often nursing home residents in one province remain in the community in the other, or how often people have long hospital stays when transferring along the continuum. We also don't know what older people think of these care options, and how often things like high user-fees stop them from using the services they want. This knowledge is required to know how care continuums are working and also to identify where improvement is needed. This research will compare the different care continuums in Manitoba and Alberta. We will first compare the number and type of services that exist and also the policies governing their use (e.g., admission criteria, user fees). Using healthcare use records from Winnipeg (Manitoba) and Edmonton (Alberta), we will then compare how people actually use these continuums along with other healthcare services (e.g., long hospital stays as people transfer from one continuing care sector to the next). We will also conduct interviews with users and providers, to get their perspective on how well their continuum works and where improvement is needed. Our results will help planners to better understand the strengths and challenges of their own care continuum, and to see the benefits of adopting certain features used elsewhere.