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 and 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 homecare 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 involves a realist review focused on a reverse logic analysis of national and international literature on high-performing home care delivery models. Component 2 relies on institutional ethnography (IE) of home care delivery and practice in 3 Canadian cities (Victoria, BC,  Winnipeg, MB, Sherbrooke, QC). IE will involve repeated participant observations and interviews in home care offices and with various home care providers, interviews with organizational leaders/key stakeholders, and collection and analysis of textual data such as documents used in home care practice (e.g., policies and procedures, assessment and documentation tools, etc.). 

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)

Co-principal applicants

Kelli Stajduhar and Damien Contandriopoulos (UVic)


Ivy Bourgeault (University of Ottawa), Annie Carrier (Université de Sherbrooke), Susan Duncan (University of Victoria), Laura Funk (University of Manitoba), Della Roberts (Island Health)


Jill Gerke (Island Health)
Lori Mitchell (Winnipeg Regional Health Authority)


Tanya Sanders (PhD Fellow)

Project Staff

Project coordinator: Ami Bitschy