The Magnitude, Share and Determinants of Private Costs Incurred by Clients (and Their Caregivers) of In-home Publicly Financed Care

Abstract

Home-based health services remain one of the fastest-growing sectors in the Canadian healthcare system. While there have been studies addressing the characteristics of home care users and the determinants of utilization, the costs associated with the use of home care services, particularly private costs, have been largely neglected. To gain a comprehensive appreciation of the financing context in which ambulatory and home-based care is delivered and received, it is imperative to assess costs incurred by clients and their family/friends. Accordingly, this study examined the magnitude and determinants of the share of private costs incurred by Ontarians who received in-home publicly financed services and by their unpaid caregivers. The private share of costs was found to be 75%. Determinants of the private share included participants' gender, martial status, functioning in activities of daily living and the type and length of service received. These findings suggest that recipients of home-based health services in Ontario may bear an economic burden when care is shifted into the home setting.