This study asked 60 case managers from seven provinces to rate 16 different vignettes and indicate the level and type of care they would recommend in regard to home care, residential care, and hospital care. Generally, it was found that significant differences existed across jurisdictions in regard to eligibility and access to services. Staff assigned to the clients also differed; for example, the expected involvement of registered nurses ranged from 93.8 per cent to 54.4 per cent across jurisdictions. Placement results also differed when case managers were blinded and then not blinded to information regarding informal support. The study makes policy suggestions, including one to standardize the understanding of “who is eligible for what” based on comprehensive assessment data, so that client needs are responded to in an effective and equitable manner.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.