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Performance Evaluation in Home and Community Care

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Abstract

Our research objective was to estimate the technical efficiency of regions in Ontario, Canada delivering home care relative to the ‘best performance’ frontier. Data Envelopment Analysis (DEA), an efficiency frontier technique, measured the technical efficiency of each geographically-defined Community Care Access Centre (CCAC) controlling for case-mix and service quality. Differences in case-mix and service quality did not fully explain the variation in efficiency scores across CCACs. Most CCACs in our sample were scale inefficient (i.e., not operating at an optimal size). The inability of home care providers to select patients or to adjust the service area is a potential explanation for the observed patterns in inefficiency. Efficiency analysis appears to represent an additional tool for use in assessing the performance of providers in the home and community care sector.

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Acknowledgements

We would like to thank the Institute for Clinical Evaluative Sciences for providing access to the Ontario Home Care Administration System database. This research was supported by funding from the Canadian Health Services Research Foundation (CHSRF)/Canadian Institutes of Health Research (CIHR) Research Training Award. We wish to acknowledge Diane Doran, Jan Barnsley and Kevin Brazil for their helpful comments and suggestions. Dr. Coyte is supported by funds from the CHSRF, CIHR, and the Ontario Ministry of Health and Long-Term Care for his Chair in Health Care Settings and Canadians.

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Authors and Affiliations

  1. Canadian Agency for Drugs and Technologies in Health, 600-865 Carling Avenue, Ottawa, ON, K1S 5S8, Canada

    Julie Polisena

  2. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

    Audrey Laporte & Peter C. Coyte

  3. Institute for Clinical Evaluative Services (ICES), Toronto, Canada

    Audrey Laporte, Peter C. Coyte & Ruth Croxford

  4. Faculty of Nursing, University of Toronto, Toronto, Canada

    Peter C. Coyte

  5. CHSRF/CIHR Health Services Chair, Health Care, Technology and Place CIHR Strategic Training Program, Toronto, Canada

    Peter C. Coyte

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  1. Julie Polisena
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  2. Audrey Laporte
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  3. Peter C. Coyte
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  4. Ruth Croxford
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Correspondence to Julie Polisena.

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Polisena, J., Laporte, A., Coyte, P.C. et al. Performance Evaluation in Home and Community Care. J Med Syst 34, 291–297 (2010). https://doi.org/10.1007/s10916-008-9240-y

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