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Ontario government commissions independent evaluation of services for seniors across the province

October 5, 2010 Toronto

Ontarians are living longer, with the number of seniors aged 85 and older increasing by nearly 37 per cent between 2003 and 2009. The Ontario government has made a substantial investment to expand community services for seniors, in an attempt to enable them to remain independent in their own homes. The Institute for Clinical Evaluative Sciences (ICES), in partnership with the Ontario Home Care Research Network, has been commissioned by the provincial government to undertake an examination of seniors’ health care in Ontario. This examination has started with a profile of Ontario seniors and how they use health care services.

“It is very important that the Ministry of Health and Long-Term Care has decided on an independent and transparent examination of its substantial investment in senior health care programs. By commissioning this work, the provincial government shows that it values the arms-length review that ICES and its collaborators can provide,” says Larry Chambers, president and chief scientist of the Élisabeth Bruyère Research Institute and an expert in health and aging research.

Aging in Ontario: An ICES Chartbook of Health Service Use by Older Adults is the first publication to come out of this work. It provides information to help the provincial government understand how seniors’ use the health care system and whether the province’s services provide the support that seniors and their caregivers need.

“As Ontarians live longer, all sectors of the health system face pressure. For example, the burden on our long-term care facilities is growing. Our data show that overall wait times for long-term care placement in Ontario have increased dramatically over time; but the news isn’t all bad. The wait times for seniors placed in crisis and from acute care facilities were shorter than those placed from other settings, which means those with the greatest need are getting served first. With this Chartbook, we are starting to gather, in one place, these important statistics on the health services used by all of Ontario seniors,” says Dr. Susan Bronskill, ICES scientist.

The Chartbook found:

  • There are significant regional differences across Ontario in how quickly long-stay home care clients receive the comprehensive, in-home assessment required to help respond to their care needs.
  • Wait times for Ontario’s long-term care facilities have increased dramatically over time, with the median wait reaching 103 days in 2009 and these wait times vary by region.
  • Seniors in crisis or waiting in hospitals are waiting shorter periods of time for long-term care placements than other applicants. Seniors aged 85-years and older were more than twice as likely as their younger counterparts to visit an emergency room for a fall-related injury.
  • The number of seniors designated as ‘alternate level of care’ in hospitals (i.e. no longer requiring acute services), and who have applied for long-term care placement, has almost doubled between 2005 and 2008.
  • There was considerable variation across Ontario in measured level of need among seniors waiting in hospital for long-term care placement.

“This Chartbook is providing the health care decision-makers with an opportunity to examine senior’s health care and use that information to improve the lives of Ontario seniors. What we know now is that there are significant regional differences in the care that seniors receive, which need to be fixed. But we also know that the seniors who are most in need of long-term care facility placement are getting a spot. The idea that a longer wait time is bad tends to dominate our thinking, but it is just a small part of the equation,” says John Hirdes, Ontario Home Care Research and Knowledge Exchange chair and professor, Health Studies and Gerontology, University of Waterloo. “On-going research is delving into the question of the needs of these seniors and the extent to which expanding their access to home care and other support services in the community is beneficial.”

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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