Problem to be Addressed - 2025 06 20



"It costs less to care for our seniors at home." This is the prevailing assumption that underpins policy and legislation shifting the work of caregiving from institutional settings to home-based settings. Policies such as "Age in Place", "Early Hospital Discharge" and even, "Hospital to Home" are all based on this idea. 

Where is the comparative cost accounting data that supports this claim? How much does it cost to operate a caregiving bed in an institutional setting? How much does it cost to operate a caregiving bed in a home-based setting? How do we measure these costs? How do we value these costs? What portion of these costs should be supported by personal financial resources? What portion of these costs should be supported by public financial resources? How do we decide the distribution of cost and responsibility? 

Is a home-based caregiving operation considered part of our overall healthcare infrastructure? What is the difference in categorization and recognition between a caregiving bed in an institutional setting and in a home-based setting?

We have research demonstrating the hardship that family caregivers endure to operate a long-term care bed in their home without adequate support from the healthcare system. These supports should match the level of resource allocation funding long-term care beds in institutional settings. This situation also begs the following questions, 

  1. "What would happen to the healthcare system if all long-term care beds, across all settings, were provided equitable distribution of resources?" 
  2. "How much of our healthcare spending is expended operating long-term care beds in institutional settings?" 
  3. "What is the proportion of private (personal) funds and government (healthcare) funds that are flowing to operate institutional long-term care beds?"
  4. "How much of our healthcare spending is expended operating long-term care beds in home-based settings?"
  5. "What is the proportion of private (personal) funds and government (healthcare) funds that are flowing to operate home-based long-term care beds?"
  6. "What would happen if home-based long-term care infrastructure collapsed and all long-term care had to be delivered in institutional settings?

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