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We estimated the impact of alternative discharge strategies, following joint replacement (JR) surgery, on acute care readmission rates and the total cost of a continuum of care. Following surgery, patients were discharged to one of four destinations. Propensity scores were used to adjust costs and outcomes for potential bias in the assignment of discharge destinations. We demonstrated that the use of rehabilitation hospitals may lower readmission rates, but at a prohibitive incremental cost of each saved readmission, that patients discharged with home care had longer acute care stays than other patients, that the provision of home care services increased health system costs, and that acute care readmission rates were greatest among patients discharged with home care. Our study should be seen as one important stepping stone towards a full economic evaluation of the continuum of care for patients. [ABSTRACT FROM AUTHOR]

Abstract: The recent growth of the home care sector combined with societal and demographic changes have given rise to concerns about the adequacy of the supply of family and friend caregivers. Potential caregivers face competing time pressures that pull them in the direction of the labour market on one hand, and towards unpaid caregiving duties on the other. This paper examines the influence of unpaid caregiving on the labour supply of a cohort of working-aged caregivers in Canada, with particular emphasis on caregiving intensity. Results suggest that caregivers are heterogeneous in both their caregiving inputs and associated labour market responses, thereby underscoring the importance of controlling for caregiving intensity when measuring labour supply. The negative influence of primary caregiving on labour supply appears to be at the level of labour force participation, rather than on hours of work or wages. [Copyright &y& Elsevier]

Abstract: A choice-theoretic model of household decision-making with respect to care-giving time allocations and the use of publicly and privately financed home care services are proposed. Predictions concerning the effect of increased availability of publicly financed home care services on home care utilization, informal care giving, and health status are derived. These predictions are assessed through use of Canadian inter-provincial survey data on home care use and care giving that are matched with data on home care funding for the period 1992–1998. Increased availability of publicly financed home care is associated with an increase in its utilization, a decline in informal care giving, and an improvement in self-reported health status. [Copyright &y& Elsevier]