I am happy to do that.
Here are some of the key findings, which are similar to what we found in other studies.
If you standardize the care need and you have a classification system that allows you to group people into similar categories of needs so that you can make apples-to-apples comparisons, it does seem to be less costly to provide care in the home. What that means in terms of possible implications for consideration by Veterans Affairs Canada is that it would be appropriate to look at whether there are any current policies that may limit the amount of resources available, and to explore whether Veterans Affairs would like to consider caring for people more actively within the community than they are currently.
Certainly the data seem to indicate that it would be less costly to care for people with similar levels of care if they were able to remain in the community, so there is an opportunity, I think, for the kind of substitution David has talked about. When doing so, one has to be somewhat careful, because just because it costs less doesn't meant it can apply to everyone. This would need to be done as part of an appropriate assessment process and so on, but the opportunity seems to be there.
The other thing is not a direct finding, but an indirect finding, as with other studies. It is that the opportunities for making those kinds of substitutions.... First of all, the data say that one can make those substitutions. Typically those substitutions are better done within an integrated program whereby you really match a program of services and procedures to the needs of the person so that it is supportive of the kind of direction that the “Keeping the Promise” document has indicated.
We've also found that the spouses make really quite a significant contribution to the care of individuals. Most of the people in the study are veterans and are men, and the spouses make a significant contribution, so if there's something that can be done to further enhance what may be done with spouses, that's something that could be considered. Certainly we now have some documentation about the contribution made by these individuals.
The other thing is that one of the key characteristics to be able to do good research, analysis, and planning is a good standardized assessment tool that has been validated, and a client classification system that's consistent across all types of care. We did use those kinds of tools in our study; we would think that consideration of that point would be very helpful. If you don't have those tools, you're not able to make the kinds of apples-to-apples comparisons that we've talked about.
The other thing that was found had to do with the kinds of services that Veterans Affairs pays for. They have a couple of programs, and there's a bit of a mixture of the kind of thing you'd usually see in a home care or continuing care program and some kinds of services that may be in an extended health benefits program. We simply point that out to see whether any consideration to perhaps recognizing those distinctions would be appropriate.
Those would be the main findings to date that we could comment on.