Where do our taxes go?

Originally published @allaboutestates.ca

Making a decision about your future or the future of an aging loved one can feel overwhelming. Not only does it take an emotional toll, but it involves knowing what care options are out there, understanding how those options can work for you and evaluating the cost of those options to pick what is best and most affordable. I have previously blogged on the out of pocket cost of care, and  thought it would be helpful to understand the cost breakdown for senior care in Ontario, to the taxpayer.  So let’s see what the costs are associated with hospital, long-term care and home care.

So what do we know? We know that the Canadian Institute for Health Information reports that seniors 65+ make up 15.6% of the population of Ontario. We also know that as a person ages, they develop increasing risk of hospitalization due to illness or injury.

The cost per patient stay in an acute care hospital, averages $5,407 in Ontario and it is even higher in Toronto at $5,910.  Analysis of this chart shows that the cost of care at home, and even in long-term care, is a fraction of the cost of hospital care.

Average Cost of Care (for one week for 424 seniors)
Hospital Bed $2.5 million ($842/person/day)
Long-term Care Bed $374,000.00 ($126/person/day)
Care at Home $125,000.00 ($42/person/day)

The costs per patient usage from the Community Care Access Centre services ranges between $2,892 and $3,775 per person; the average was about $3,400 per person. (Source:  http://www.homecareontario.ca/home-care-services/facts-figures/publiclyfundedhomecare.  Table: (2011) HOME First Shifts care of Seniors to HOME. LHINfo Minute, Northeastern Ontario Health Care Update).

While care at home is often the preferred option, it is not always possible, especially for frail seniors who are alone, without family or friends closeby. Many of these seniors end up in the hospital and from there they have no place to go.

The challenges continue as there is a shortage of Long Term Care beds. Many seniors who are awaiting placement find themselves now labeled as Alternative Level of Care. (ALC).  The Provincial ALC definition is:When a patient is occupying a bed in a hospital and does not require the intensity of resources/services provided in this care setting (Acute, Complex Continuing Care, Mental Health or Rehabilitation), the patient must be designated Alternate Level of Care (ALC) at that time by the physician or her/his delegate. The ALC wait period starts at the time of designation and ends at the time of discharge/transfer to a discharge destination (or when the patient’s needs or condition changes and the designation of ALC no longer applies).”

I have a client who has spent 3 years awaiting placement and he continues to live under ALC status in a downtown hospital. A very sad and costly situation for everyone, including taxpayers.

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