Original Title: Portrait de l’utilisation des services visant à répondre aux besoins médicaux des aînés qui reçoivent des services de soutien à domicile

Authors' objectives: The objective of this overview is to provide indicators pertaining to services used to address the medical needs of senior home care users and outline factors that may influence the use of these services. This work will make service use indicators available to the ministère de la Santé et des Services sociaux (MSSS) and to managers across Quebec's regions, which may be useful when reflecting on the organization of services to better meet the medical needs of senior home care users.

Authors' results and conclusions: RESULTS (#1 SOCIODEMOGRAPHIC CHARACTERISTICS OF SENIOR HOME CARE (SAPA) USERS): There are wide variations in the rate of senior home care (SAPA) users across regions (between 7% and 13%), and this holds true even after adjusting for age, gender and number of health conditions. (#2 USE OF SERVICES AIMED AT ADDRESSING MEDICAL NEEDS-HOME CARE SERVICES ): There are significant regional disparities in the total number of professional home care interventions delivered to users of SAPA programs. (#2 USE OF SERVICES AIMED AT ADDRESSING MEDICAL NEEDS-MEDICAL AND PHARMACEUTICAL SERVICES IN PRIMARY CARE): Senior home care (SAPA) users have frequent interactions with family physicians, averaging 3,7 visits per year with either a family doctor or a primary care nurse practitioner. They also receive an average of two clinical primary care services per year from a community pharmacist. (#2.1 USE OF SERVICES AIMED AT ADDRESSING MEDICAL NEEDS-MEDICAL AND PHARMACEUTICAL SERVICES IN PRIMARY CARE): The proportion of senior home care (SAPA) users who were hospitalized is relatively consistent across regions, ranging from 41% to 48%. The provincial average of 44% is significantly higher than the 12% observed among the general population aged 65 and over in Quebec but aligns closely with findings described in international studies of older adults receiving home care, which range from 43% to 46%. (#3 KEY FACTORS INFLUENCING SERVICE UTILIZATION-CLINICAL FACTORS): Senior home care (SAPA) users with functional impairments use more medical services, such as home visits by physicians, emergency department visits, and hospital admissions. According to the advisory committee, falls are a common reason for emergency department visits among senior home care (SAPA) users with mobility challenges. (#3.1 KEY FACTORS INFLUENCING SERVICE UTILIZATION-SOCIODEMOGRAPHIC FACTORS): Individuals aged 80 and over appear to be more likely to be hospitalized. Women tend to make more frequent emergency department visits, while men are more often admitted to hospital. However, these factors do not account for the regional variations observed in this overview, as adjustments were made to minimize their influence. (#3.2 KEY FACTORS INFLUENCING SERVICE UTILIZATION-ACCESS-RELATED FACTORS): Physician visits at home or in clinics outside regular business hours are associated with reduced rates of emergency department visits and hospitalizations. (#3.3 KEY FACTORS INFLUENCING SERVICE UTILIZATION-ACCESS-RELATED FACTORS): Clear communication of clinical information across different services and the presence of a designated coordinator may help reduce emergency department visits. CONCLUSION: This overview provides new insights into the services used by older adults receiving professional home care services in Quebec to address their medical needs. The findings offer valuable data to the ministère de la Santé et des Services sociaux and managers across Quebec’s regions to inform reflections regarding service organization.

Authors' methods: This overview is based on three sources of information: • An analysis of clinical administrative data Nine service use indicators designed to meet the medical needs of senior home care users were calculated for 2023-2024 from the information available in clinical and administrative databases. The results were broken down according to certain sociodemographic and health characteristics, as well as health regions. • A rapid review and narrative summary of the literature The literature review helped identify factors influencing the use of medical services by seniors receiving home care. A total of 51 studies and 5 literature reviews published since 2019 were included. • Consultations A committee of experts in health databases was consulted to ensure the relevance and quality of the indicators derived from clinical administrative databases. An advisory committee was also involved in helping interpret and contextualize certain results. This committee included a researcher, clinicians (physicians, nurses, a pharmacist), senior nursing advisors and home care program managers. Finally, members of INESSS’s Panel des usagers et des proches de la Direction de l’évaluation et du soutien à l’amélioration des modes d’intervention – services sociaux et santé mentale (DESA) were invited to inform discussions on the concerns and challenges that senior home care users and their caregivers may experience.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/portrait-de-lutilisation-des-services-visant-a-repondre-aux-besoins-medicaux-des-aines-qui-recoivent-des-services-de-soutien-a-domicile.html

Year Published: 2025

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/portrait-de-lutilisation-des-services-visant-a-repondre-aux-besoins-medicaux-des-aines-qui-recoivent-des-services-de-soutien-a-domicile.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)