An evaluation of contracted palliative care home care services in Ontario,Canada

As a money-saving strategy, the majority of western countries have been mov ing away from institutionalized care and gravitating towards a home-based c are system. Home care services continue to be promoted and a growing variet y of services have become widely available, with palliative care being a re cent addition. While this continues to occur, the Ontario provincial govern ment has instigated a number of additional money-saving strategies specific to home care. These include a complete restructuring of how home care serv ices are oganized and the emergence of a 'request for proposals process', w here for-profit home care agencies compete together with not-for-profit age ncies to win one of the numerous public contracts available through one of the province's 43 Community Care Access Centres (CCAC). This paper presents an evaluation of the palliative care services as given by the agencies con tracted to do so by the Niagara Community Care Access Centre. Using a multi -dimensional research strategy that includes stakeholder surveys, case mana ger interviews and client surveys, the evaluation research results allow th e Niagara CCAC to make an evidence-based decision regarding the palliative care contract renewal. (C) 2001 Elsevier Science Ltd. All rights reserved.