Emergent Issues in Directly-Funded Care: Canadian Perspectives

Area of Science:

• Health Services Research
• Public Health Policy
• Social Gerontology

Background:

• Direct Funding (DF) allows individuals to manage their home care budgets, differing from publicly arranged services.
• While DF programs exist in Canada, research on their features and impacts is limited.
• A health equity framework guided this study to address knowledge gaps on Canadian DF programs.

Purpose of the Study:

• To identify the characteristics of Direct Funding programs across Canada.
• To explore emerging issues in DF program design and policy development.
• To extend the knowledge base on DF from a Canadian perspective using an environmental scan.

Main Methods:

• Qualitative environmental scan design.
• Data collection via questionnaires and semi-structured interviews with 23 participants.
• Analysis of features across 20 DF programs.

Main Results:

• A summary table detailing features of 20 DF programs was created.
• Key interview themes included a lack of information on DF workers and concerns about home care agencies' increasing role.
• Findings suggest potential for DF to improve rural access and outcomes for minority groups.

Conclusions:

• Direct Funding expansion in Canada may enhance health equity by supporting personal networks for hiring home care workers.
• Monitoring socioeconomic disparities in DF access is crucial.
• Policy design should avoid mandating independent self-management, which can disadvantage individuals with cognitive impairments.