We also examined the problems with care continuity that clients experienced, the implementation of the competitive contracting model, and the impact of competitive contracting on continuity of care and the consistency of homecare personnel for clients in one Ontario community. [...] Policy makers must think of the homecare sector in terms of the broader healthcare system, and they need to pay greater attention to the factors that promote continuity of care. [...] The Approach Over the two years of the study, we used a variety of research approaches to develop an understanding of continuity of homecare and the issues surrounding it. [...] The Homecare Sector in the City of Hamilton The Hamilton CCAC, one of the largest in Ontario, serves a population of about 500,000 and was one of the last to be established, in October 1997. [...] The first competitive bidding process was initiated soon after the CCAC’s establishment, and the first service contracts were awarded in November 1998 for approximately one-third of all nursing and homemaking services provided in the region to clients living in the downtown “core” area of the city.
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