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New Brunswickers' Experiences with Home Care

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New Brunswickers' Experiences with Home Care New Brunswickers’ Experiences With Home Care 2012 Survey Results New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) About us: Who we are: New Brunswickers have a right to be aware of the decisions being made, to be part of the decision-making process, and to be aware of the outcomes delivered by the health system and its cost. The New Brunswick Health Council will foster this transparency, engagement, and accountability by engaging citizens in a meaningful dialogue, measuring, monitoring, and evaluating population health and health service quality, informing citizens on health system performance and recommending improvements to health system partners. For more information: New Brunswick Health Council Pavillon J.-Raymond-Frenette 100 des Aboiteaux Street, suite 2200 Moncton, NB E1A 7R1 Phone: 1.877.225.2521 1.506.869.6870 Fax: 1.506.869.6282 www.nbhc.ca How to cite this document: New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Cette publication est disponible en français sous le titre: Expérience des Néo-Brunswickois et Néo-Brunswickoises à l’égard des soins à domicile, Résultats du sondage 2012 (CSNB 2012) Page | 2 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Table of Contents Executive Summary ………………………………………………………………………………………………………………………………… 5 Introduction ……………………………………………………………………………………………………………………………………………. 11 Managing Chronic Health Conditions ……………………………………………………………………………………………………… 14 Caregiver Profile …………………………………………………………………………………………………………………………………….. 15 Unmet Needs …………………………………………………………………………………………………………………………………………. 15 Navigation Between Home Care Services in New Brunswick ………………………………………………………………….. 16 Quality of Service …………………………………………………………………………………………………………………………………… 16 Extra-Mural Program …………………………………………………………………………………………………………………………. 16 Home Support Services ……………………………………………………………………………………………………………………… 19 Home Care Communities ……………………………………………………………………………………………………………………….. 20 Glossary …………………………………………………………………………………………………………………………………………………. 21 Survey Methodology ………………………………………………………………………………………………………………………………. 23 Target Population …………………………………………………………………………………………………………………………………… 24 Questionnaire Design …………………………………………………………………………………………………………………………….. 25 Sampling ………………………………………………………………………………………………………………………………………………… 25 Communication Plan ………………………………………………………………………………………………………………………………. 26 Data Collection ………………………………………………………………………………………………………………………………………. 26 Confidentiality and Privacy …………………………………………………………………………………………………………………….. 27 Data Limitations …………………………………………………………………………………………………………………………………….. 27 Estimation ………………………………………………………………………………………………………………………………………………. 28 Page | 3 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Survey Results ………………………………………………………………………………………………………………………………………… 29 Provincial Results ……………………………………………………………………………………………………………………………………. 31 Extra-Mural Program: Comparing health zones to NB ……………………………………………………………………….. 34 Extra-Mural Program: By Respondent Demographics ………………………………………………………………………… 35 Home Support Services: Comparing health zones to NB ……………………………………………………………………. 41 Home Support Services: By Respondent Demographics …………………………………………………………………….. 42 Results by Health Zone …………………………………………………………………………………………………………………………… 48 Results by Community ……………………………………………………………………………………………………………………………. 77 References ……………………………………………………………………………………………………………………………………………… 191 Appendix A: Caregiver Profile by Community …………………………………………………………………………………………. 193 Appendix B: Definitions ………………………………………………………………………………………………………………………….. 197 Appendix C: Map of 7 Health Zones ………………………………………………………………………………………………………… 201 Appendix D: Map of 28 Communities ……………………………………………………………………………………………………… 205 Appendix E: Cities, Towns and Villages Included in Each Community ………………………………………………………. 209 Appendix F: Survey Questionnaire ………………………………………………………………………………………………………….. 215 Page | 4 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Executive Summary Citizens should be given the opportunity to express their opinions about the home care services they receive in New Brunswick. When possible, many New Brunswickers want the ability to be cared for at home, rather than in a hospital, special care home or nursing home. Home care services can help people stay in their own home and function as independently as possible in the context of their daily lives. The New Brunswick Health Council (NBHC) is releasing the results of its 2012 Home Care Survey. This telephone survey was conducted with citizens across all communities in New Brunswick who have recently received home care services, with the cost being entirely or partially covered by government. The New Brunswick Home Care Survey has resulted in a sample of 4,246 completed surveys. The New Brunswick Home Care Survey is a unique opportunity for citizens in all communities to share their views and help drive improvements in home care services. The results of this survey will provide baseline data that can help decision-makers with the planning, funding and establishing benchmarks/targets for the improvement of services and related outcomes over time. From the citizen’s point of view, home care navigation and coordination cannot focus exclusively on services received at home, but rather on the continuum of care between all health care sectors. Home care is most cost-effective when it is integrated with other parts of the health care system1. For the purposes of this survey, home care services have been divided into two separate categories. The first category of home care includes clinical/medical services provided by health professionals under New Brunswick’s two regional health authorities and throughout this report will be referred to as the Extra-Mural Program. The second category of home care services encompasses personal care services provided by home support workers. This second category will be referred to as Home Support Services. The Department of Social Development funds home support services, entirely or partially, based on eligibility. 1 Seniors in Need, Caregivers in Distress: What are the home care priorities for seniors in Canada? (April 2012), Health Council of Canada Page | 5 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Survey results in this report are always presented in one of three categories: (1) citizens receiving services from the Extra-Mural Program (n=3,153), (2) citizens receiving home support services (n=1,905), and (3) all home care recipients combined (n=4,246). Figure 1. Survey Respondents by Category Extra-Mural Program (EMP) Home Support Services (HSS) n = 2,341 n = 812 n = 1,093 EMP n = 3,153 HSS n = 1,905 n = 4,246 Page | 6 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Managing Chronic Health Conditions When asked if a doctor or any other health professional has ever Figure 2. Citizens Receiving Home Care diagnosed them or treated them for a chronic condition, 93% of survey Services in New Brunswick: Number of respondents reported they had at least one chronic condition (among Self-reported Chronic Health Conditions arthritis, asthma, chronic pain, emphysema or chronic obstructive pulmonary disease (COPD), cancer, diabetes, Alzheimer’s disease, 7% dementia, depression or any other mood disorder, heart disease, stroke, None high blood pressure or gastric reflux), and nearly one-third of 32% respondents receiving home care have five or more chronic conditions. 27% 1-2 3-4 Understanding the health profile of citizens receiving home care is extremely important in managing chronic health conditions and 5 or more ultimately reducing the number of hospital admissions and visits to the 34% hospital emergency room. Caregiver Profile Many citizens receiving home care rely on a caregiver such as family members, friends or others who provide unpaid care. In the New Brunswick Home Care Survey, 62% of respondents reported that a caregiver helps them with their home care, and of these, nearly 6 in 10 get help every day. Caregivers play an important role in ensuring a better quality of life for home care recipients and in helping them to continue living independently in their community. Unmet Needs Looking at unmet needs reported by survey respondents, 11% believe that more could have been done to help them stay at home. When asked what could have been done, the top three responses overall were: 1. Improve/Increase hours covered (for example nights and weekends) 2. Expand scope of home support services available (for example housekeeping, food delivery, or yard work) 3. Reduce the burden of cost (for example medications/prescriptions) Page | 7 New Brunswickers’ Experiences with Home Care, 2012 Survey Results (NBHC 2012) Collaboration and Navigation Across Government Departments Home care services in New Brunswick, when covered entirely or partially by public funds, are administered under two different government departments. The Department of Health funds the Extra-Mural Program and the Department of Social Development funds home support services. Based on the New Brunswick Home Care Survey, 26% of respondents who receive care from the Extra-Mural Program reported that they also receive home support services. Coordination of care and navigation become key elements of focus for citizens who need both types of home care services to stay in their own home. Therefore, collaboration between the Department of Health
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