Tackling the Home Care Challenge

Population aging, technological advancements and burgeoning costs are expected to contribute to growth within and demands on the Canadian home care sector. Several reports highlight the growing demand for home care and the urgent need to re-envision a publicly funded home care system that promotes equitable and consistent access to care for older adults that is sustainable into the future.  

There is little empirically based research into the contextual forces, structural characteristics, and operational processes shaping the practice, delivery, and organization of publicly funded home care in Canada. Such evidence is needed to inform promising practices to enable sustainable, equitable, and consistent access to quality care at home. 

Study description 

The project rests on two complementary research components pursued simultaneously to address the study objectives.

Component 1: a realist review focused on a reverse logic analysis of national and international literature on high-performing home care delivery models.

Component 2: institutional ethnography (IE) of home care service delivery and practice in three Canadian cities (Victoria, BC, Winnipeg, Manitoba, Sherbrooke, Québec). IE will involve repeated participant observations and interviews alongside the collection and analysis of documents (paper, electronic) within each of the three participating cities’ home care offices. 

Likewise, in all three cities, interviews will be done with various allied health professionals, organizational leaders, and key stakeholders to provide local context and history around the delivery of home care services.  

Research objective 

The overall goal of this study is to inform and support the development of promising practices to enable equitable and consistent access to high quality home care in Canada. 

  • Describe and understand the structural characteristics and operational processes of high-performing home care delivery models; 
  • Provide a detailed contextual description of home care practice and the macro and meso-level factors that currently and historically shape the delivery of publicly-funded home care in 3 Canadian provinces; 
  • Explore how the everyday delivery and practice of home care in these provinces might contribute to the production of disparities both between and within provinces; and 
  • Contrast current home care service delivery models in Canada with promising practices internationally. 


Funding for this project has been provided by the Canadian Institutes of Health Research (CIHR)


  • Kelli Stajduhar (Co-Principal Applicant, UVic)
  • Damien Contandriopoulos (Co-Principal Applicant, UVic)
  • Ivy Bourgeault (Co-Applicant, University of Ottawa)
  • Annie Carrier (Co-Applicant, Université de Sherbrooke)
  • Susan Duncan (Co-Applicant, University of Victoria)
  • Laura Funk (Co-Applicant, University of Manitoba)
  • Della Roberts (Co-Applicant, Island Health)
  • Jill Gerke (Collaborator, Island Health)
  • Lori Mitchell (Collaborator, Winnipeg Regional Health Authority)


  • Alexandra Éthier (Graduate Student Fellow, Université de Sherbrooke, Québec)
  • Cynthia (Cindy) Yamamoto (Graduate Student Fellow, University of Manitoba, Manitoba)
  • Tanya Sanders (Graduate Student Fellow, University of Victoria, British Columbia)

Project Staff 

  • Ami Bitschy, Research Coordinator (BC) 
  • Melissa Giesbrecht, Research Associate (BC)
  • Julie Rempel, Site Coordinator (MB)
  • Michaël Beaudoin, Site Coordinator (QC)