Bridging the Islands: Re-Building BC’sHome & Community Care System – A Policy Paper by BC’s Physicians

This paper examines British Columbia’s Home and Community Care (HCC) system. The image of islands provides an apt metaphor to describe the services in British Columbia’s HCC system. Just as our ability to cross islands easily depends on the quality of the bridges between them, so does a patient’s ability to move between services depend on the quality of the links between components of the system. If there is one message from both the literature and our survey respondents, it is that greater investment in and integration of the islands of care is necessary to improve the quality of care, manage resources effectively, and meet the needs of our aging population.

To understand the challenges and opportunities facing the system, the Doctors of BC HCC Project Group reviewed the relevant peer-reviewed literature, government reports, and policy papers and conducted surveys and in-depth interviews of Doctors of BC members and HCC case managers from across the province. For purposes of this paper, HCC is defined as the range of services for dependent people who require help with day-to-day living, life skills, and chronic disease management over an extended period of time. While a primary focus is on older populations who make up the majority of HCC patients (e.g., frail elderly), it also includes those who require home and community care services but for whom appropriate resources are lacking (e.g., patients with brain injuries, addictions, chronic mental illness). Given the unique needs of hospice, palliative, and post-acute care patients, we exclude them from our analysis.

For the full policy paper, please see “Bridging the Islands: Re-Building BC’s Home & Community Care System".