Long-term care: expansion or contraction?

A 2011 Conference Board of Canada report done for the for-profit long-term care (LTC) facilities in Ontario estimates (based on population projections and utilization by age) that 238,000 Ontarians will be in need of long-term care by 2035. This compares with about 98,000 today.

So we are looking at a need to increase long-term care 143%.

With a 1.5% annual increase in the number of LTC beds, the Conference Board estimates Ontario would be 127,000 beds short of need, with the gap gradually increasing year by year until 2035. That's an increase of 103,000 from the current wait list of 24,000.

The report notes that government policies could affect utilization. Certainly, this is what the government appears to be hoping to achieve. But even moderating the huge growth in need would require some big leaps in policy handiwork. A more likely scenario may just be to provide less care to those in need.

Compounding the problem, the Liberal government may not choose to increase LTC bed stock by even 1.5% per year.

The Conference Board report sits at odds with a 2012 report also sponsored by the for-profit homes discussed yesterday. Far from increasing long-term care beds at even the modest pace of 1.5% per year, that report suggested reducing the number of long-term care beds and increasing short stay beds focused more on the treatment of patients rather than the daily living activities of residents.

That strategy may sound good to a government focused on cutting costs and reining in the number of long-term care beds, but it doesn't appear to deal with some basic demographic realities.

The current wait list blew up in just a few years -- a bigger list may be coming if the government doesn't develop long-term care.

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