Research Project

Project Publication

Project Team

  • Contact: Kimberlyn McGrail
  • Anne-Marie Broemeling
  • Margaret McGregor, CHSPR Associate and Family Practice, Faculty of Medicine, UBC
  • Kia Salomons
  • Lisa Ronald

Research Areas

BC seniors’ use of home health care services: Population-based Description and Health Status Comparison

Home and community care services are designed to help individuals with acute, chronic, palliative or rehabilitative health care needs remain in the community as long as possible. Home care services— provided at home to clients who would otherwise require admission to a hospital or long-term care facility—represent a growing and increasingly important component of the health system. Adjusted for inflation, per capita government spending on home care in Canada rose from $55 in 1994 to $93 in 2003. Total public spending on home care reached $3.4 billion in 2003, or roughly 3.7% of total public health spending.

In British Columbia, in-home services include home care nursing, rehabilitation, home support and palliative care. Community-based services include adult day programs and meal programs.

Beginning in the mid-1990s, this sector of the health system underwent a series of major transitions in the province. Services were regionalized, with health authorities assuming responsibility for the organization, funding, and in many cases, direct delivery of care. A large number of other policy changes followed, and some of these policies were implemented differently, and at different times, across health authorities.


This one-year, British Columbia Ministry of Health Services-funded report provides policy makers and researchers with a population-based profile of users of home support, community rehabilitation, home nursing care and adult day-program services in the province.

It is one of the first studies of its kind to incorporate health status measures, and compare the health status of seniors using these services to the health of community-dwelling seniors who don’t use home health services.

In particular, the project investigated:

  • What is the demographic profile of long-term home health services users, and how do they differ from community-dwelling seniors who don’t use home health services? How does the use of services differ across the province?
  • How does the health status of long-term home health services users compare to the health status of seniors who don’t use home health services?
  • Has the use of home care services changed over time? What are the characteristics (age, gender, geography and co-morbidities) of long-term home health services users over time, and how does this compare with the profile of other seniors?

The project also investigated the relationship between the use of home health services and the use of other health services—residential care, acute care and physician services.


The report covers the years 1995/96 through 2004/05, using data on continuing care service use in the BC Linked Health Database. It includes the population aged 65 and over, and concentrates on long-term users of home health services.

Adjusted Clinical Groups (ACGs) and Expanded Diagnosis Clusters (EDCs) are used to describe (and adjust for) health status.


  • BC Ministry of Health Services
  • Provincial Home and Community Care Council


  • British Columbia Ministry of Health