Concept: Access to Home Care

Introduction

This concepts describes three measures that were developed to measure the populations access to Home Care. These include:


1. Percent of Residents in Home Care;
   
2. New Home Care Clients; and
   
3. Days Registered with the Home Care Program - Duration

This concept also provides a link to relevant SAS code. Please see the SAS code and formats section containing the following link: Home Care Access SAS Code - (internal access only).

1. Percent of Residents in Home Care

The percent of residents who were open in the Home Care program indicates the percent of residents who were registered with the Home Care program for at least one day during the year.

Note: Clients who received assessments only were included in the count of clients for the home care report. Ideally, one would be able to determine who received just assessments, and include them or exclude them as appropriate. However, currently it is impossible to determine who received only assessments. A similar problem was encountered for defining new clients.

This differs from the percent of residents who received services in the Home Care program, which indicates the percent of residents who were registered with the Home Care program and received at least one direct service visit during the year.
• Due to the gaps in the service data this measure cannot currently be accurately computed, however examples of how such a measure may look are given in the Perspectives on Home Care Data Requirements report.

2. New Home Care Clients

The new home care clients/100 residents measure is defined using the number of home care clients with a start date in the home care program after April 1st (i.e. after the fiscal year start) as the numerator. The denominator is made up of the residents of Manitoba. Note the difference between this measure and the access to home care is that people who were on home care at the beginning of the year are not included in this measure.

The new home care clients/100 clients measure is the percentage of clients that were new that year ^{1, 2} .

Note: Writing around this variable is a bit difficult given its definition because it is incorrect to say "a new client is someone who was not registered with the program in the previous year" or some such variation.
• New projects may want to consider actually defining this concept that way.

3. Days Registered with the Home Care Program - Duration

The number of days that a client file is open is determined using registration and termination dates. If a client is opened to more than one type of service at the same time, the days are not double counted. This does not indicate the proportion of time that a client was actively receiving services, and in fact is not highly correlated to the number of service days or hours (see discussion in Roos, NP et al. (Dec. 2001) ).

The number of days registered in home care/client is an indication of the average time that clients are registered with the home care program per year or over multiple years.

The number of days registered in home care/100 residents combines information on how many people are registered with the home care program, with an indication of the length of time that they are registered.

Footnotes:

¹ 95% of new clients had not been registered with the Program in the previous 6 months; 90% had not been registered in the previous year. For 6 to 8% of the new clients, the only service they appear to have received was the assessment; for all others, their home care file remained open for a week or more during the year, and it is likely that they received one or more home care services.

² When an individual had more than one home care episode in a fiscal year they would only be counted once as a new client. (7.8% of Home Care clients in 1998/99 had more than one episode in the year and 5.9% of the new Home Care clients had two or more episodes in 1998/99).