Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-07T20:02:50.721Z Has data issue: false hasContentIssue false

L'Évaluation de la politique des services à domicile du ministère des affaires sociales: étude de cas

Published online by Cambridge University Press:  29 November 2010

François Béland
Affiliation:
Cité de la Santé de Laval

Abstract

A partial evaluation of the comprehensive home care and home aid policy of the Ministry of Social Affairs (MAS) of Quebec was undertaken. Three different home care and/or home aid programs serving three urban catchment areas were compared for this purpose. Two of these programs offer comprehensive home care and home aid programs, while the third one offers nursing services at home only. One hundred clients from each program were interviewed at their admission and six months later. Three random samples of elderly from each of the catchment areas were also drawn to take into account local characteristics in the comparison of the clienteles. The study has shown that 1) the three clienteles do not differ except on a few variables. These differences are not systematically related to the type of program (comprehensive/nursing only). 2) That the clients who, on admission, have the profile closest to the client profile established by MAS, were among those that the interviewers could not find for the second interview. And, 3) a comparison of the clients of three programs (on living arrangements, functional impairments and chronic illness), with that of a random subsample of the elderly population, have shown that the former have a higher probability than the latter to wish to leave home. Thus the two comprehensive home care programs seem to experience difficulties in reaching the goals that the ministerial policy has set forth for them.

Résumé

Une évaluation partielle de la politique des services à domicile du Ministère des Affaires sociales du Québec (MAS) a été entreprise en comparant la clientèle de trois programmes de services ou de soins à domicile de trois milieux urbains du Québec. Deux de ces programmes offrent des services globaux à domicile, tandis que le troisième programme n'ofrre que des services infirmiers. Une observation de 100 clients de chacun des programmes à leur admission et six mois plus tard, avec contrôle, à l'aide d'échantillons de population âgée locale, sur les idiosyncrasies locales permet de conclure que 1) les clientèles des programmes globaux ne diffèrent pas entre elles, 2) que les clients qui, àl'admission, sont les plus proches de la clientèlecible définit par le MAS du Québec, sont introuvables six mois plus tard et 3) que les clients des trois programmes désirent plus quitter le domicile qu'un sous-échantillon de population âgée, présentant des caractéristiques isomorphes à celles de la clientèle. En somme, les deux programmes de services globaux à domicile ont éprouvé de la difficulté à atteindre les buts que s'était fixé le MAS dans son énoncé de politique.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGAPHIE

Adams, A. T. et Tolhurst, M. B. (1969), The care of patients with long-term illness after their discharge from hospital, The Medical Journal of Australia, 2: 806809.CrossRefGoogle ScholarPubMed
AHPQ (1967), Conferences prononcées à la session d'étude consacrée aux services coordonnés de soins à domicile, Québec, Association des hopitaux de la Province de Québec.Google Scholar
Barry, D. (1975), How to keep the elderly at home Modern Healthcare, avril: 2932.Google Scholar
Beattie, N. M. (1976), Aging and the social services. In Binstock, R. H. et Shanas, E., Handbook of Aging and the Social Sciences, pp. 619642, New York, Van Nostrand Reinhold.Google Scholar
Bell, B. D. (1973), The family life cycle, primary relationships, and social participation patterns. The Gerontologist 13: 7881.CrossRefGoogle Scholar
Béland, F. (1980), Méthodologie pour l'evaluation de programmes socio-sanitaires: le cas des services à domicile pour personnes âgées, Québec, Laboratoire de recherches sociologiques, cahier 15, Université Laval.Google Scholar
Béland, F. (1981), L'aide aux personnes âgées, leurs incapacités fonctionnelles et leurs désirs d'hébergement: les résultats d'une étude empirique. In Tilquin, C., Systems Science in Health Care, Tome II, pp. 12631277, Toronto: Pergamon.Google Scholar
Berg, R. L., Browning, F. E., Hill, J. G., et Wenkert, W. (1970), Assessing the health care needs of the aged, Health Services Research, 5.Google ScholarPubMed
Besner, M. (1969), L'hôpital se fait maternel, L'infirmière canadienne, mars: 2023.Google Scholar
Bishop, Y., Fienberg, S., Holland, P. (1975). Discrete Multivariate Analysis, BostonM.I.T.Google Scholar
Bodenheim, Parris, R. (1974) Physical therapy and the geriatric patient in the community, Physical Therapy, 54: 1819.Google Scholar
Brickner, P. W. et al (1975), The home bound aged, Annals of Internal Medicine, 82: 16.CrossRefGoogle Scholar
Branch, C. G., Callahan, J. J., Jette, A. M., Targeting home care services to vulnerable elders: Massachusetts' home care corporations, Home Health Care Services Quarterly, 2: 4159.CrossRefGoogle Scholar
Brunet, M. (1978), Le professionnalisme, obstacle au changement social. Un cas type: l'équipe multidisciplinaire de santé. Recherches sociographiques, 19: 261269.CrossRefGoogle Scholar
Cang, S. et Clarke, F. (1978), Home care of the sick; an emerging general analysis based on scheme in France, Community Health, 9: 167172.Google ScholarPubMed
Chappel, N. L. et Penning, M. H. (1979), The trend away from institutionalization: Humanism or economic efficiency? Research on Aging, 1: 361387.CrossRefGoogle Scholar
Doherty, N., Segal, J. et Hicks, B. (1978), Alternative to institutionalization for the aged: viability and cost effectiveness. Aged Care and Services Review, 1: 116.Google ScholarPubMed
Gerson, L. W. et Hughes, O. P. (1976), A comparative study of the economics of home care, International Journal of Health Services, 6: 543555.CrossRefGoogle ScholarPubMed
Goodman, L. A. (1968), The analysis of cross-classified data: Independence, quasi-independence, and interactions in contingency tables with or without missing entries, Journal of the American Statistical Association, 63: 10711131.Google Scholar
Haberman, J. (1978), Analysis of Qualitative Data, Vol. 1, New York, Academic Press.Google Scholar
Hill, J. G. et al (1968), Health Care of the Aged Study, part I, Rochester, University of Rochester.Google Scholar
Isaacs, B. et Neville, Y. (1976), The needs of old people, the “intervals” as a method of measurement. British Journal of Preventive and Social Medicine, 30: 7985.Google Scholar
Kane, R. L. et Kane, R. A. (1980), Long-term care: can our society meet the needs of its elderly? Annual Review of Public Health, 1: 227253.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Downs, T. D., Adams, M. et Rusby, D. I. (1972), The Effects of Continued Care: A Study of Chronic Illness in the Home, Washington, DHEW.Google Scholar
M.D.E.A. (1976), Home Care: An Alternative to Institutionalization, Boston, Massachusetts, Dept. of Elder Affairs, National Technical Information Service.Google Scholar
MAS (1979), La politique des services à domicile, Québec, Ministère des Affaires sociales, Gouvernement du Québec.Google Scholar
MAS (1980), Pour mieux vieillir au Québec, Québec, Ministère des Affaires sociales, Gouvernement du Québec.Google Scholar
Moriwaki, S. Y. (1973), Self-disclosure, significant others and psychological well-being in old age, Journal of Health and Social Behavior, 14: 226232.CrossRefGoogle ScholarPubMed
Morris, R. (1969), Aging and the field of social work. In Riley, M. W., Riley, J. W. et Johnson, M. E., Aging and Society, vol. III, Aging and the Profession, pp. 1854, New York, Russell Sage Foundation.Google Scholar
Neilson, M., Blenkner, M., Bloom, M., Downs, T., Beggs, H. (1972), Older persons after hospitalization: a controlled study of home aid service, American Journal of Public Health, 62: 10941101.Google Scholar
Shanas, E. (1971), Measuring the home health needs of the aged in five counties, Journal of Gerontology, 26: 3740.CrossRefGoogle Scholar
Shapiro, E. (1979), Home Care: A Comprehensive Overview, Ottawa, Health and Welfare.Google Scholar
Stewart, J. E. (1969), Home Health Care, St. Louis, Mosby.Google Scholar
Susser, M. (1969), Aging and the field of public health. In Riley, M. W., Riley, J. W. et Johnson, M. E., Aging and Society, vol. II, Aging and the Professions, pp. 44160, New York, Russell Sage Foundation.Google Scholar
Tolkoff-Rubin, M., Fisher, S., O'Brien, J. et Rubin, R. (1978), Coordinated Home-Care: The Massachusetts General Hospital Experience, Medical Care, 16: 453464.CrossRefGoogle ScholarPubMed
Wartski, S. A. et Green, D. S. (1971), Evaluation in a home-care program, Medical Care, 9: 352364.CrossRefGoogle Scholar
Weissert, W. G., Wan, T. T. H., Levieratos, B. B., Pellegino, J. (1980), Cost-effectiveness of homemaker services for the chronically ill, Inquiry, 19: 320–243.Google Scholar