An evaluation of contracted palliative care home care services in Ontario, Canada

As a money-saving strategy, the majority of western countries have been moving away from institutionalized care and gravitating towards a home-based care system. Home care services continue to be promoted and a growing variety of services have become widely available, with palliative care being a recent addition. While this continues to occur, the Ontario provincial government has instigated a number of additional money-saving strategies specific to home care. These include a complete restructuring of how home care services are oganized and the emergence of a ‘request for proposals process’, where for-profit home care agencies compete together with not-for-profit agencies to win one of the numerous public contracts available through one of the province's 43 Community Care Access Centres (CCAC). This paper presents an evaluation of the palliative care services as given by the agencies contracted to do so by the Niagara Community Care Access Centre. Using a multi-dimensional research strategy that includes stakeholder surveys, case manager interviews and client surveys, the evaluation research results allow the Niagara CCAC to make an evidence-based decision regarding the palliative care contract renewal.