Grant: Project Grant - Priority Announcement: Patient-Oriented Research

Most older adults want to stay in their homes as they age. Home care helps make that possible. It includes paid services (for example, nurses or personal support workers) and unpaid help from family and friends. Governments have increased funding for home and community care, yet it is still unclear which mix of paid and unpaid support best prevents avoidable hospital visits, delays transition to long-term care, and uses public dollars wisely. Provinces also organize home care differently, so what works in one place may not work in another. This study will follow Canadians from the Canadian Longitudinal Study on Aging and securely link their survey responses with provincial health records in British Columbia, Ontario, and New Brunswick. We will track how people's home care use changes over time and identify common patterns (for example, mostly family help, a mix of family and paid help, or increasing paid help). We will then examine how these patterns relate to future outcomes such as emergency department visits, hospital stays, transitions to long-term care, and overall health system costs. We will also look at differences in outcomes by income, rural or urban residence, sex and gender, and other social factors. Finally, we will test what-if policy scenarios, such as increasing paid home care hours for people with high needs, to estimate the likely health benefits, budget impact, and value for money. Our goal is to generate evidence to help provinces target home care investments so more older adults can remain safely at home, caregivers are better supported, and the health system avoids preventable and costly hospital and long-term care use. Findings will be shared with patients, caregivers, and policy-makers to support better decisions.