Skip to main content
SpringerLink
Log in

A deterministic model of home and community care client counts in British Columbia

  • Published:
Health Care Management Science Aims and scope Submit manuscript

Abstract

In British Columbia (BC) Home and Community Care (HCC) services provide a range of health care and support services for British Columbians with acute, chronic, palliative or rehabilitative health care needs. Although it is not surprising that almost 80% of HCC clients are senior citizens (aged 65 and older), this does lead to some concern. In particular, the most recent population projections suggest that the senior population of BC will double in the next twenty years. Predicting how this will impact HCC is of high importance in preparing for future years. In this paper we discuss the development of a deterministic multi-state Markov model of the HCC system, its validation, and its predictions for future client counts for various HCC client groupings. This model was originally developed for the BC Ministry of Health Services, and is currently being used as a first step to developing a strategic direction plan for BC’s HCC sector. The model makes several notable steps forward in terms of research and modelling of HCC. First, past literature regarding models of HCC appears to be only concerned with publicly funded (government run) residential care environments. Our model advances this in two directions by including at home care and non-publicly funded care. Second, our model considers both the predicted changes in the age demographics of British Columbia, as well as the predicted changes in the relationship between age and health status.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Notes

  1. The British term residential care corresponds to what Canada refers to as “assisted living”, while the British term “nursing care” corresponds to the Canadian term residential care.

  2. The client contribution for a publicly-run assisted living environment is based on 70% of the client annual income, to a maximum value of the regional market value of care. However, it is worth noting that the client cost formula for residential care services is more complicated, so this is only a very rough benchmark of the client costs for publicly funded AEs.

References

  1. Statistics Canada (2008) Canada’s national statistics agency. Canada population summary statistics. http://www.statcan.ca/

  2. U.S.A. Central Intelligence Agency (2007) The world factbook. https://www.cia.gov/library/publications/the-world-factbook/

  3. Special Feature Article (2006) Migration rates and the age composition of interprovincial movers. BC Stats, Migration Highlights, Fourth Quarter:1–4. http://www.bcstats.gov.bc.ca/pubs/pr_mig.asp

  4. Bergheim S (2006) Live long and prosper! Health and longevity as growth drivers. Deutsche Bank Research, Frankfurt

    Google Scholar 

  5. Berlin R, Ramlo A, Baxter D (2006) Seniors’ housing demand in British Columbia over the next 30 years. Number 65 in Urban Futures Reports. Urban Futures

  6. Christodoulou G, Taylor GJ (2001) Using a continuous time hidden Markov process, with covariates, to model bed occupancy of people aged over 65 years. Health Care Manage Sci 4:21–24

    Article  Google Scholar 

  7. Cranswick K, Thomas D (2005) Elder care and the complexities of social networks. Can Soc Trends 77(11):10–15

    Google Scholar 

  8. Dodd H (2007) Non-publicly funded senior accommodation environments in British Columbia. CSMG Technical Report. http://osler.irmacs.sfu.ca/HCC/

  9. Ehrenfeld M (1998) Nursing and home care in Europe. Int Nurs Rev 45(2):61–64

    Article  Google Scholar 

  10. El-Darzi E, Vasilakis C, Chaussalet T, Millard PH (1998) A simulation modelling approach to evaluating length of stay, occupancy, emptiness and bed blocking in a hospital geriatric department. Health Care Manage Sci 1:143–149

    Article  Google Scholar 

  11. Evans RG (1987) Hang together, or hang separately: the viability of a universal health care system in an aging society. Can Public Policy 13(2):165–180

    Article  Google Scholar 

  12. Organisation for Economic Co-operation and Development (2005) Long-term care for older people. OECD, Issy les Moulineaux

  13. Canadian Health Services Research Foundation (2001) Myth: the aging population will overwhelm the healthcare system. Prepared by the Knowledge Transfer Department

  14. Frederick JA, Fast JE (1999) Eldercare in Canada: who does how much? Can Soc Trends 54:26–31

    Google Scholar 

  15. Hare W, Dodd H (2008) Non-publicly funded accommodation environments in British Columbia: survey and analysis. J Popul Ageing (submitted)

  16. Hill GB, Forbes WF, Lindsay J, McDowell I (1997) Life expectancy and dementia in Canada: the Canadian study of health and aging. Chronic Dis Can 18(4):3. http://www.phac-aspc.gc.ca/publicat/cdic-mcc/18-4/c_e.html

    Google Scholar 

  17. Kirkpatrick S, Gelatt CD, Vecchi Jr MP (1983) Optimization by simulated annealing. Science 220(4598):671–680

    Article  Google Scholar 

  18. Kristjansson B, Helliwell B, Forbes WF, Hill GB (2000) Marital status, dementia and institutional residence among elderly Canadians: the Canadian study of health and aging. Chronic Dis Can 20(4):1–11

    Google Scholar 

  19. MacAdam M (2004) Examining home care in other countries: the policy issues. Home Health Care Manag Pract 16(5):393–404

    Article  Google Scholar 

  20. McGrail KM, Green B, Barer ML, Evans RG, Hertzman C, Normand C (2000) Age, costs of acute and long-term care and proximity to death: evidence for 1987-88 and 1994-95 in British Columbia. Age Ageing 29:249–253

    Article  Google Scholar 

  21. Millard PH, Christodoulou G, Jagger C, Harrison GW, McClean SI (2001) Modelling hospital and social care bed occupancy and use by elderly people in an English health district. Health Care Manage Sci 4:57–62

    Article  Google Scholar 

  22. Moore EG, Rosenberg MW, Fitzgibbon SH (1999) Activity limitation and chronic conditions in Canada’s elderly, 1986–2011. Disabil Rehabil 21(5/6):196–210

    Google Scholar 

  23. Prior PM, Hayes BC (2003) The relationship between marital status and health: an empirical investigation of differences in bed occupancy within health and social care facilities in Britain, 1921–1991. J Fam Issues 24(1):124–148

    Article  Google Scholar 

  24. Rosenberg MW, Moore EG (1997) The health of Canada’s elderly population: current status and future implications. Can Med Assoc J 157:1025–1032

    Google Scholar 

  25. Sheps SB, Reid RJ, Barer ML, Krueger H, McGrail KM, Green B, Evans RG, Hertzman C (2000) Hospital downsizing and trends in health care use among elderly people in British Columbia. Can Med Assoc J 163(4):397–401

    Google Scholar 

  26. Sivamurthy M, Wadakannavar AR (2001) Care and support for the elderly population in India: results from a survey of the aged in rural north Karnataka. Paper presented at the IUSSP General Population Conference, Salvador, 18–24 August 2001

  27. Skinner BJ, Rovere M (2006) Paying more, getting less 2006: measuring the sustainability of public health insurance in Canada. Fraser Institute Digital Publication

  28. B.C. Stats. (2008) British Columbia population summary statistics. http://www.bcstats.gov.bc.ca/

  29. B.C. Stats. (2007) Population extrapolation for organization planning with less error (p.e.o.p.l.e.), run cycle 32. Provided by the B.C. Ministry of Health.

  30. Stoddart H, Whitley E, Harvey I, Sharp D (2002) What determines the use of home care services by elderly people? Health Soc Care Community 10(5):348–360

    Article  Google Scholar 

  31. Tomiak M, Berthelot J-M, Guimond E, Mustard CA (2000) Factors associated with nursing-home entry for elders in Manitoba, Canada. J Gerontol Medial Sci 55(A):M279–M287

    Google Scholar 

  32. Xie H, Chaussalet TJ, Millard PH (2005) A continuous time Markov model for the length of stay of elderly people in institutional long-term care. J R Stat Soc A 168(1):51–61

    Article  Google Scholar 

  33. Xie H, Chaussalet TJ, Millard PH (2006) A model-based approach to the analysis of patterns of length of stay in institutional long-term care. IEEE Trans Inf Technol Biomed 10(3):512–518

    Article  Google Scholar 

  34. Yang Z, Norton EC, Stearns SC (2003) Longevity and health care expenditures: the real reasons older people spend more. J Gerontol 58B(1):S2–S10

    Google Scholar 

  35. Zhan HJ, Liu G, Guan X, Bai H (2006) Recent developments in institutional elder care in China: changing concepts and attitudes. J Aging Soc Policy 18(2):85–108

    Article  Google Scholar 

Download references

Acknowledgements

We are indebted to the continual assistance from the BC Ministry of Health Services and Regional Health Authorities. In particular, Karyn Archibald, Martha Burd, Sandra Feltham, and Bonnie Hallas, have been instrumental in the success of this work. We would also like to gratefully acknowledge the anonymous referees of this work, whose insights and feedback vastly improved the clarity and scope of this work.

W.L. Hare research supported in part by NSERC Discovery Grant 611523. H. Dodd research supported by NSERC USRA. All authors research supported in part by BC Ministry of Health.

Author information

Authors and Affiliations

  1. Modelling of Complex Social Systems (MoCSSy) Program, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada

    W. L. Hare & A. Alimadad

  2. Complex Systems Modelling Group (CSMG), IRMACS, Simon Fraser University, Burnaby, British Columbia, V5A 1S6, Canada

    W. L. Hare, A. Alimadad, H. Dodd, R. Ferguson & A. Rutherford

Authors
  1. W. L. Hare
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Alimadad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Dodd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Ferguson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Rutherford
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. L. Hare.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hare, W.L., Alimadad, A., Dodd, H. et al. A deterministic model of home and community care client counts in British Columbia. Health Care Manag Sci 12, 80–98 (2009). https://doi.org/10.1007/s10729-008-9082-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10729-008-9082-7

Keywords

Search

Navigation