Social Policy in Ontario

Crusading for truth in health spending, Oct. 17

Bob Hepburn’s article raises some important questions about how we keep track of the dollars that are spent on health care. The basic numbers are readily available to the public, and familiar to many. The Ontario government spends $2.2 billion per year on home care — about 4 per cent of the total health-care budget.

Of every dollar that Community Care Access Centres receive, 91.3 cents are spent on delivering health-care services directly to patients. The CCACs’ general administrative costs have been reduced from 4.6 per cent three years ago to 4.4 per cent at present. In addition, only a small portion of the CCACs’ budget — 1.5 per cent — is spent on office and clinic space, and 2.3 per cent is spent on information technology.

Mr. Hepburn and his source take issue with these numbers. Their view is that care coordination is overhead; this is inaccurate. Care coordination is care delivery, as patients and families who have dealt the health system and home care can attest. Care coordinators work with patients, their families, family physicians, nurse practitioners, pharmacists and a range of other care providers, including nurses, physiotherapists, occupational therapists, nutritional therapists, social workers, and personal support workers.

CCAC care coordinators themselves are frontline regulated health care professionals — nurses, social workers, physiotherapists and others with specialized clinical expertise. Care coordination is part of all aspects of health care, such as family health teams, hospitals, and clinics.

These functions are not overhead or administration; they are recognized internationally as direct care.

This kind of coordination is delivering results. Over the past three years, CCACs have increased the number of patients who have returned home from hospital instead of going to a long-term care home by about 26 per cent and they have reduced wait times for patients referred through the community by 24 per cent for nine tenths of their patients.

Sharon Baker, Chief Operating Officer, Ontario Association of Community Care Access Centres, Toronto

< http://www.thestar.com/opinion/letters_to_the_editors/2013/10/20/clarifying_health_care_spending.html >