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Informing Policy

How do Canadians living with chronic conditions use at-home care?

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A new CHÉOS health economics analysis could help policymakers plan for the future and understand how to support care for an aging population.

Dr. Wei Zhang

The study, penned by CHÉOS Scientist Dr. Wei Zhang and senior statistician Dr. Huiying Sun, compared the amount of at-home care required by people living with different chronic conditions across Canada.

Specifically, the study compared how middle-aged and older adults living with different chronic conditions use formal (professional workers) and informal (family and friends) care at home.

“Both formal and informal care are important to the health care system because they allow people with some serious conditions to live at home,” explained Dr. Zhang, Program Head of Health Economics at CHÉOS. “This reduces the need for other health care services like nursing homes and hospital visits.”

Huiying Sun

In 2018, 10 per cent of the Canadian population (3 million people) received some amount of at-home care. However, little is known about the demand for home care across different diseases, and this missing information matters when planning and allocating resources to support the population.

“Informal care may reduce the need for health care spending but the societal costs and burden on informal caregivers can also be significant,” said Dr. Zhang.

Even less is known about the sex and gender differences in who receives what type of care.

“From a gendered perspective, women are more likely to suffer from age-related conditions and may have different care needs compared to men,” she noted.

Drs. Zhang and Sun used data from the Canadian Longitudinal Study on Aging (CLSA), a representative sample of over 50,000 Canadians and one of the largest and most comprehensive datasets on health and aging. The researchers compared the likelihood of needing formal and informal care, and the amount of care needed, across sixteen distinct chronic conditions in people 45 years of age and older.

The researchers found that multiple sclerosis (MS), Parkinson’s disease, memory problems, and stroke were the chronic conditions requiring the most formal and informal care in both women and men.

Overall, women were more likely to receive care and received more hours of at-home care than men.
However, for some diseases, the difference in the amount of care used between people living with and without a chronic condition was much greater in men compared to women. In other words, men generally used less at-home care but the jump in usage related to living with a chronic condition was more severe in men, compared to women.

For example, men living with MS used an average of 152 “extra” hours of at-home formal care per year compared to men without MS — women with MS only used an extra 53 hours.

“These findings have important implications for policy and will help decision-makers recognize the demand for both formal and informal care in our aging population, and allocate resources accordingly” said Dr. Zhang.

The authors also note that the results, which are representative of over 12 million Canadians, can be used as a basis to evaluate cost savings related to the implementation of chronic disease management programs.

Questions remain about the relationship between formal and informal care for different chronic conditions: can one type of care replace the other or should governments support both types? Dr. Zhang and Sun aim to answer these questions in an upcoming publication.

The study was published in PLOS ONE.

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