Demand for home and community care is expected to grow dramatically as the population ages. Planning for the future of the sector requires that its current economic footprint be understood.

Total estimated spending on home and community care in 2010 ranged from $8.9 billion to $10.5 billion, accounting for between 4.6 and 5.5 per cent of total health spending in Canada. Between 22 and 27 per cent was paid by private sources.

There are opportunities to address key health system challenges by substituting home and community care services for acute or long-term services.

The home and community care sector relies heavily on volunteer efforts and unpaid care, something that raises concerns about the sustainability of the sector going forward. The estimated cost to Canadian businesses was over $1.28 billion in 2007 in lost productivity as a result of caregivers missing full days of work, missing hours of work, or even quitting or losing their jobs.

Executive Summary

Chapter 1—Defining the Home and Community Care Sector

• Introduction
• What Is Home and Community Care?
• Why Is Understanding the Home and Community Care Footprint So Important?

Chapter 2—Approach Used to Estimate the Home and Community Care Footprint

• Process for Estimating the Home and Community Care Footprint
• Exploring the Potential Impacts of Substitution

Chapter 3—The Economic Footprint of Canada’s Home and Community Care Sector

• Background
• Public Home Health Spending
• Public Home Support Spending
• Private Home Health Spending
• Private Home Support Spending
• Combined Public and Private Home Care Spending
• Hours of Care Provided by Home Care
• Estimated Employment Supported by Home Care
• Public Community Care Spending
• Private Community Care Spending
• Combined Public and Private Community Care Spending
• Combined Home and Community Care Spending
• Home Care Recipients and Informal Caregivers
• Cost to Business of Caregiving
• Volunteers and Volunteer Hours
• Number of Home Health Care Service Establishments
• Summary of the Economic Footprint of the Home and Community Care Sector

Chapter 4—Spending Implications of Substitution

• What Is Substitution?
• Where Does It Apply?
• Are There Cost Implications?
• What Could This Mean for the Home and Community Care Footprint?

Chapter 5—Implications for the Future of Home and Community Care

Appendix A—Methodology Used to Assemble the Economic Footprint of Canada’s Home and Community Care Sector

• Home Care Indicators
• Community Care
• Other Economic Footprint Indicators

Appendix B—Data Sources Used to Assemble the Economic Footprint of Canada’s Home and Community Care Sector

• Public Home Health Spending
• Public Home Support Spending
• Private Home Care Spending (Total)
• Private Home Health Spending
• Private Home Support Spending
• Public Community Care Services Spending
• Private Community Care Spending
• Volunteers and Informal Caregivers

Appendix C—Public Home Health Spending

Appendix D—Public Home Support Spending

Appendix E—Private Home Health Spending

Appendix F—Private Home Support Spending

Appendix G—Combined Public and Private Home Care Spending

Appendix H—Home Care Spending as a Share of Total Health Spending

Appendix I—Hours of Care Provided by Ontario’s Community Care Access Centre

Appendix J—Community Care Spending

Appendix K—Community Care Hours

Appendix L—Volunteers

Appendix M—Bibliography