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Successful Hospital-to-Home Program Enhances Need for Home Caregiver Funding

The success of a national initiative to help people with chronic diseases manage their condition at home highlights the importance of the CMA’s recommendation that the federal government develop explicit guidelines on home caregiver funding.

More than 2,000 Canadians with chronic obstructive pulmonary disease (COPD) who took part in the INSPIRED collaboration have endured 64% fewer hospital readmissions and 53% fewer emergency department visits since the program launched in 2014–15.

The INSPIRED innovation involves health organizations identifying patients admitted to hospital with advanced COPD and providing services and support to them and their families so they can manage their illness outside the hospital. On the basis of extensive input from patients and their caregivers, the INSPIRED program equips them with written action plans, regular phone contact after hospital discharge and at later intervals, education on self-management, psychosocial support and advance care planning.

The program, developed in Halifax and partially funded by the Canadian Foundation for Healthcare Improvement (CFHI), is expanding to include an additional 2,300 people by early 2019. The innovation is expected to significantly reduce health care costs: according to a third-party analysis commissioned by CFHI, every dollar spent on an INSPIRED approach prevents $21 in acute-care hospital costs. Boosting patients’ control and confidence in managing their disease at home also provides them with a better quality of life.

COPD, a chronic and progressive lung disease that includes chronic bronchitis and emphysema, accounts for more Canadian hospital admissions from emergency department visits and readmissions than any other chronic disease.

COPD’s impact is expected to only worsen, as an estimated one in four Canadians will develop the debilitating disease within their lifetime, reinforcing the CMA’s call for financial support for caregivers who help patients both in their homes and in their communities.

The federal government has earmarked funding of $6 billion over 10 years to provinces and territories for home care, including support for caregivers. Clear guidelines on the deployment of this funding, both for caregivers’ costs and for caregiver respite, will help seniors, including those with COPD and other chronic diseases, to remain in their homes.

Already, the cost to employers in lost productivity because of absenteeism of caregivers is estimated at $5.5 billion per year. Caregivers also face high personal expenses.

It’s a depressingly common phenomenon for seniors to be forced from their homes because their needs aren’t met there. Investing in caregivers will help ensure a sustainable solution to an aging population requiring — and aspiring to — home care.