The Canadian Home Care Association has released a study that found that while most provinces have emphasized the need to step up funding for care provided outside of hospitals, none have followed through on their verbal commitments.
The Portraits of Home Care report calculated the average amount per capita spent on health care based on budgets from all 10 provinces and three territories. The association found that of the $3,957 spent on each person in 2010, only $159 or four per cent was earmarked for home care.
Those levels have remained fairly stable over the past five years, Association Executive Director Nadine Henningsen said, adding some provinces have even reduced overall home care funding.
Henningsen said the same story has played out in Ottawa where the federal government shoulders responsibility for offering health coverage to First Nations Canadians, veterans, RCMP employees and members of the Department of National Defence. Henningsen said those programs could not be directly compared to provincial offerings, but said a funding shortfall for home care was equally evident.
The overall trend, she said, is a home care budget that doesn't live up to expectations.
"Verbally we see a commitment to shifting more care towards the home," Henningsen said in a telephone interview. "What we noticed from putting this report together is that the percentage of the public funding certainly didn't reflect those messages or that direction."
The report said demand for home care is soaring as Canada's baby boomers enter their twilight years. About 1.4 million people accessed home care services in 2011, up 55 per cent from 2008.
Henningsen said the shift is not surprising, since home care often reduces the amount of time ailing people spend in hospital and improves their overall quality of life.
But home care is not without its trials, she said. Lack of funding means vulnerable people are on the hook for expensive drugs that are no longer covered once a patient has left hospital. A funding shortfall often results in a lack of community resources, leaving patients without care for extended stretches.
The burden is often taken up by family members and the strain on those providing the bulk of the in-home care must be considered in any funding plan, she said.
The report said 10 of Canada's provinces and territories have begun to address the problem by compiling a home care strategy, though Henningsen said none of the plans tabled so far are complete.
Ontario, for instance, has implemented a broad funding model that offers better than average drug coverage without providing help for caregivers, while Nova Scotia has managed to offer compensation for such people despite a more restricted overall budget, she said.
Such a measure would be welcome across the country, she said, adding support for caregivers may help head off a future crisis for a system that's already overtaxed.
"If we don't support these family caregivers, they're going to burn out, they're going to get sick and they're going to end up in the health care system too," she said.
Henningsen said the association would like to see all orders of government redistribute their health care budgets to make home care a higher priority. She said new cash would not be necessary, adding reallocating funds currently devoted to other areas would go a long way towards addressing the shortfall.
Henningsen also called for a more united approach to home care from all provinces and territories. While she said the problem can't be resolved with a one size fits all approach, she argued governments should agree on basic core services that would be offered from coast to coast.
Health Canada, which researches and analyzes home care across the country, said the federal government has taken steps to make home care a higher priority. Ottawa has allocated $30.3 billion in fiscal transfers that provinces will spend on health care, the department said, adding the recent budget offers more tax relief for home care services.
"The government is committed to a strong, publicly funded, universally accessible health care system for Canadians," Health Canada said in a statement. "With the actions the government has taken to grow transfers to provinces and territories to record sustainable levels, we are helping ensure health care and other vital services will be there for Canadian families when and where they need them."
Henningsen said the country's demographics make a strong case for immediate action on home care, adding any government moves would likely be hailed as good news.
"We know that Canadians, they prefer to receive their care at home," she said. "It can happen, it should happen, so let's make it happen."