Welfare Reform on the Web (July 2004): Social Care - Overseas

THE DESIRE FOR SUPPORT AND RESPITE CARE: PREFERENCES OF DUTCH INFORMAL CAREGIVERS

M.A. Koopmanschap and others

Health Policy, Vol. 68, 2004, p.309-320

Informal care has become an indispensable element in the care for many dependent elderly and chronically ill patients and yet the needs of informal carers have largely been neglected in the literature. The article investigates 950 Dutch informal caregivers' preferences for support and respite care. Results showed that almost 80% of carers wanted support and respite care, with between 42-47% of those requiring either more interaction with other informal caregivers or more information from professional caregivers, and 40% seeking time off. Caregiver characteristics, such as age, employment status, health and relationship with the care recipient, influence the desire for support and respite care. The article concludes that giving informal caregivers the support they need is important if the future supply of this important element of healthcare is to be secured.

MANAGING UNDER MANAGED COMMUNITY CARE: THE EXPERIENCES OF CLIENTS, PROVIDERS AND MANAGERS IN ONTARIO'S COMPETITIVE HOME CARE SECTOR

J. Abelson and others

Health Policy, Vol. 68, 2004, p.359-372

In 1996 the government of Ontario introduced a managed competition environment into the home care sector through the establishment of a competitive contracting process for home care services. The article traces the implementation of this policy and assesses the effects of competitive contracting on two sets of goals:

• quality of care goals that consider continuity of care of paramount importance in the provision of home care;
• the managed competition goal of increased efficiency.

In assessing the implementation of this policy against these goals, article highlights the conflicts that can arise in pursuing different policy goals in response to different formulations of the policy problem that underpin them.