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Indicator Metadata

Name

Wait Times for Home Care Services

Short/Other Names

Home Care Wait Times

Description

The median number of calendar days that clients waited, from the date that the initial referral was received to the date when the first home care service was received.

Includes only services that are provided, coordinated or primarily funded by the government. This may include cases where a copay is required.

For the purpose of this indicator, home health is defined as services provided by home health care professionals (e.g., nurses, physiotherapists, occupational therapists, clinical nutritionists).

Home support means assistance provided to clients to enable them to live at home. Includes only homemaking and personal care.

Interpretation

A low number is desirable for this indicator

HSP Framework Dimension

Health System Outputs: Access to comprehensive, high-quality health services

Areas of Need

Getting Better

Geographic Coverage

Prince Edward Island, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, Northwest Territories

Reporting Level/Disaggregation

National, Province/Territory

Indicator Results

https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en

Identifying Information
Name

Wait Times for Home Care Services

Short/Other Names

Home Care Wait Times

Indicator Description and Calculation
Description

The median number of calendar days that clients waited, from the date that the initial referral was received to the date when the first home care service was received.

Includes only services that are provided, coordinated or primarily funded by the government. This may include cases where a copay is required.

For the purpose of this indicator, home health is defined as services provided by home health care professionals (e.g., nurses, physiotherapists, occupational therapists, clinical nutritionists).

Home support means assistance provided to clients to enable them to live at home. Includes only homemaking and personal care.

Calculation: Description

The number of days that half of the clients waited for their first home care service and half were still waiting.

Start time: The date that the initial referral is received
Note: For clients who are in hospital when the referral is received, the start time will be the date they are discharged from hospital.

Stop time: The date when the first service is received (i.e., first home care event). This care event should not be for the sole purpose of conducting an assessment, arranging a service visit or checking in with the client.

Unit of analysis: Referral for home care service

Calculation of all-Canada estimates: The pan-Canadian value is calculated using a weighted average of the median wait times submitted by jurisdictions. Weights are calculated using the volumes of referrals submitted by jurisdictions.

Calculation: Geographic Assignment

Place of service

Calculation: Type of Measurement

Number - Median (50th percentile) length of time, in days

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Not applicable

Numerator

Description:
The median number of calendar days that clients waited for their first home care service
Inclusions:

  1. The first of either home health services or home support services
    1. Home health includes services provided by any health care professional (e.g., nurses, physiotherapists, occupational therapists).
    2. Home support is limited to personal care and homemaking. Other home support services, such as home maintenance/adaptation or respite services, are not included.
  2. All ages
  3. All priority/urgency levels
  4. Only new referrals (i.e., referrals for new clients or clients who are being referred for a new episode of care)
  5. Home care visits in any setting
  6. Only face-to-face visits for home health (i.e., in person, videoconference)
  7. Only in-person visits for home support
  8. Referrals from hospital; the date of discharge from hospital is the start date of the wait time for these clients
  9. Client unavailable days (i.e., days when the client was not available to attend the appointment are included)
  10. System delays (i.e., days when the health care provider was not available to offer the service are included)
  11. Only cases where the stop time (i.e., first home care service) occurred within the reporting fiscal year (April 1 to March 31)

Exclusions:

  1. Phone and email communications
  2. Home care services primarily funded by the government and arranged by the client
Background, Interpretation and Benchmarks
Rationale

Indicators of wait times are of high interest to both the Canadian public and system managers, as they reflect important aspects of experiences of care and of the responsiveness of the health system. Measuring wait times provides an indication of whether Canadians are getting timely access to home care services in the community.

Many factors affect wait times, such as availability of home care services and providers, the number of people requiring home care services, urgency of the client’s condition and client choice.

This indicator can be used to understand access to home care in the community and to know how jurisdictions are performing in terms of providing timely access to home care services.

Interpretation

A low number is desirable for this indicator

HSP Framework Dimension

Health System Outputs: Access to comprehensive, high-quality health services

Areas of Need

Getting Better

Targets/Benchmarks

Not applicable

References

Canadian Institute for Health Information. Glossary of terms. In: CIHI. Standards for Management Information Systems in Canadian Health Service Organizations. 2016.
Canadian Institute for Health Information. Glossary of terms. In: CIHI. Standards for Management Information Systems in Canadian Health Service Organizations. 2019.
Canadian Institute for Health Information. Home Care Reporting System Data Submission Specifications Manual. 2018.

Availability of Data Sources and Results
Data Sources

Provincial and territorial data collection systems

Available Data Years

Type of Year:
Fiscal
First Available Year:
2019
Last Available Year:
2019

Geographic Coverage

Prince Edward Island, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, Northwest Territories

Reporting Level/Disaggregation

National, Province/Territory

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Your Health System: In Brief
URL: https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en

Updates

Not applicable

Quality Statement
Caveats and Limitations
  • Caution should be used when interpreting this data. The data comes from independent provincial and territorial systems, which have known variations in definitions. There is a commitment among jurisdictions to work toward harmonizing definitions and improving comparability of results.
  • Data coverage varies across Canada.
  • Differences in the organization, funding and availability of services and care providers will influence wait times across provinces and territories.
  • Differences across jurisdictions in terms of which clients qualify to receive publicly funded home care can influence wait times.
  • There is no standard urgency classification or common benchmark wait time across the country, and clients of all urgency levels have been included. Differences in the mix of acuity levels across jurisdictions may result in differences in wait times.
  • Days where the client is unavailable are included.
  • There are cases where delays to care are appropriate (e.g., scheduled bandage change). These delays will still be captured in the wait time.

Jurisdiction-specific challenges

  • Prince Edward Island reports only nursing for home care. Data is missing for approximately 50% of clients because the current data collection process does not capture allied health professionals. This may result in longer wait times, as allied health professionals may visit a client first and make a request for nursing or home support services. Wait times may also be longer when a referral for service is received in advance of the date the scheduled service is required. Home care provided in hospital is not included. No data was available by gender or sex.
  • For New Brunswick, results are not shown due to insufficient data coverage and are not included in the Canada value. For more information, see the 2021 Shared Health Priorities companion report.
  • In Quebec, the referral date is used for clients referred from hospital. In general, the client is seen by a health professional before receiving home support. The first assignment to home care is initiated by the health professional (nurse, social worker or occupational therapist). Data is recorded by sex instead of gender.
  • In Ontario, school services are excluded.
  • In Manitoba, the data submitted is for the Winnipeg Regional Health Authority (WRHA) only. The indicator includes cases when the first service was attempted to be delivered but the client was not at home. Services provided in WRHA Home Care community intravenous (IV) clinics and services that are provided by contracted private agencies are excluded. Manitoba does not provide data by client type. Data for approximately 50% of clients in the province is missing.
  • Saskatchewan home care visits include all modalities because of an inability to determine whether the visit was conducted in person, by phone or by videoconference. Data is recorded by sex instead of gender.
  • Alberta data is recorded by sex instead of gender. Data is missing for approximately 30% of clients in the province due to incomplete data in Calgary Zone.
  • In British Columbia, new referrals for recurrent clients are included. British Columbia does not provide data by client type. Data is recorded by sex instead of gender.
  • Home support services in the Northwest Territories are not limited to in-person home visits, as clients in rural communities may receive transportation and social supports. All home care data is recorded by sex, categorized as male, female and X. Data also does not allow for reliable alignment of clients to the 5 client types used by CIHI (i.e., acute, end-of-life care, long-term supportive care, maintenance, rehabilitation). Northwest Territories data has been organized into 3 client types: acute, end-of-life care and long-term supportive care. Data is missing for approximately 7% of clients because of incomplete or missed submissions from community-level service providers.
  • No data is available at this time for Newfoundland and Labrador, Nova Scotia, Yukon and Nunavut.
Trending Issues Not applicable
Comments This indicator belongs to the Shared Health Priorities portfolio measuring access to mental health and addictions services and to home and community care.

More information on this indicator will be available in the 2021 companion report on the Shared Health Priorities page.