Decision makers' allocation of home-care therapy services: a process map

Area of Science:

• Health Services Research
• Rehabilitation Sciences
• Healthcare Management

Background:

• Home care services are crucial for managing complex, long-stay clients.
• Effective allocation of occupational and physical therapy is vital for client outcomes.
• Ontario's home care system faces challenges in service delivery.

Purpose of the Study:

• To investigate the decision-making processes for allocating occupational and physical therapy services.
• Focus on complex, long-stay clients within the Ontario home care context.

Main Methods:

• Exploratory study utilizing key-informant interviews and client vignettes.
• Involved home care decision-makers (case managers, directors) across four Ontario regions.
• Data analyzed using the framework analysis method.

Main Results:

• Identified a four-stage decision-making process: intake, assessment, referral, and reassessment.
• Significant variations exist in service volume determination across regions, driven by financial constraints.
• Government funding and information sharing methods heavily influence therapy allocation.

Conclusions:

• Financial constraints are the primary factor influencing therapy service allocation in Ontario home care.
• Current healthcare cost inflation necessitates innovative funding and service delivery models.
• Proactive care is essential to prevent client deterioration and reduce long-term care costs.