Are chronically ill XXXX high users of homecare services in Canada?

@entity1 @entity102
OBJECTIVES: @entity102 @entity1 often need healthcare and supportive services, with formal homecare services an important source of community-based assistance. Although @entity1 diagnosed with 1 or more @entity102 are thought to be the most common homecare clients, and perhaps the highest users of homecare services, few studies have analyzed homecare services utilization by specific clients. A study was done to determine if a relationship exists between @entity102 and homecare services utilization. STUDY DESIGN: Descriptive-comparative, secondary analysis of population homecare data. METHODS: Three years (2003-2004, 2004-2005, and 2005-2006) of complete homecare client and services utilization data for 1 Canadian province were obtained and tested using 5 definitions of @entity102 to determine which clients among all 149,378 were high users in terms of annual homecare hours and service visits or episodes. RESULTS: Two definitions revealed clients with a disproportionately large share of homecare hours and service episodes: a) clients classified by homecare case managers as "long-term" and b) clients with service spans of >= 90 days. Definitions involving medical diagnoses and International Classification of Diseases, Ninth Revision, Clinical Modification codes or chapters did not reveal high users. Age and gender also did not predict services utilization. CONCLUSIONS: The comprehensive pre-service assessment completed by homecare case managers was the most successful at distinguishing @entity1 with substantial homecare service needs- @entity1 who could then be described as chronically ill. This assessment should be studied to develop a standardized minimum data tool for consistent and fair assessments.
