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Formal home care use in Canada.

BACKGROUND
Formal home care services (those typically delivered by health care providers or volunteer organizations) are different from informal home care services (given by family, friends or neighbours), and thus represent a partial picture of all home care provided. Home care has been associated with decreased mortality, improved quality of life, and reduced hospitalizations and health care costs.


DATA AND METHODS
New data from the annual Canadian Community Health Survey (CCHS) 2015/2016 are used to estimate, for the first time, the number and percentage of households in which at least one person of any age received formal home care services in Canada during the previous year. A descriptive analysis of socioeconomic characteristics of households receiving formal home care is presented.


RESULTS
An estimated 6.4% of households (881,800) in Canada received formal home care services in the past year, most frequently nursing (46%) and personal/home support services (46%). Households with parents and adult children (age 25 or older), one-person households, and households with lower socioeconomic status were most likely to have received formal home care. Costs were covered by a range of sources. They were paid solely by government (52%), solely out of pocket (27%), solely by insurance (7%), at least partially by insurance and/or government (8%), and by other sources (6%). Households that received home health care services only-particularly nursing services-were more likely to have their costs entirely covered by government, while those that received support services only were more likely to pay out-of-pocket costs.


DISCUSSION
This descriptive analysis of household use of formal home care services by socioeconomic characteristics and type of care will help inform health care policies and programs. Future person-level analysis can examine the independent factors associated with home care use.