Managing under Managed Community Care: The Experiences of Clients, Providers and Managers in Ontario's Competitive Home Care Sector

Julia Abelson (), Sara Tedford, Christel Woodward (), Denise O'Connor () and Brian Hutchison ()
Additional contact information
Julia Abelson: Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University
Sara Tedford: Department of Sociology, McMaster University
Christel Woodward: Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University
Denise O'Connor: Department of Political Science, McMaster University
Brian Hutchison: Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, Department of Family Medicine, McMaster University

No 2003-04, Centre for Health Economics and Policy Analysis Working Paper Series from Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada

Abstract: In 1996, a newly elected government in the Province of Ontario, Canada, introduced a managed competition environment into the home care sector through the establishment of a competitive contracting process for home care services. Through 65 in-depth, semi-structured interviews conducted between November 1999 and January 2001, we trace the implementation of this competition contracting policy within Ontario's newly established managed community care environment and assess the effects of competitive contracting against two sets of goals: 1) quality of care goals that consider continuity of care of paramount importance in the provision of home care; and 2) the managed competition goal of increased efficiency. In assessing the implementation of this policy against these goals, we highlight the conflicts that can arise in pursuing different policy goals in response to different formulations of the policy problem that underpin them. We map stakeholder experiences with the competitive contracting policy onto relevant contracting and managed competition literatures. When measured against the goals of quality of care and efficiency, the findings presented here offer a mixed review of the experiences to date with the competitive contracting process introduced in Ontario's home care sector and suggest improvements for managing future competitive contracting processes.

Keywords: home care policy; Canada; competitive contracting; managed competition (search for similar items in EconPapers)
Pages: 31 pages
Date: 2003
References: Add references at CitEc
Citations:

Downloads: (external link)
http://www.chepa.org/Files/Working%20Papers/03-04.pdf First version, 2003 (application/pdf)
Our link check indicates that this URL is bad, the error code is: 404 Not Found

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hpa:wpaper:200304

Access Statistics for this paper

More papers in Centre for Health Economics and Policy Analysis Working Paper Series from Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada Contact information at EDIRC.
Bibliographic data for series maintained by Lyn Sauberli ( this e-mail address is bad, please contact ).