BALANCE OF CARE
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The Balance of Care (BoC) Research and Evaluation Group is a collaborative of established health services researchers and graduate students based at the University of Toronto. Led by Professor A. Paul Williams (CRNCC Co-Chair), the Group’s work focuses on access to, and the cost-effectiveness of, community-based programs and services for vulnerable groups and individuals including older persons at risk of institutionalization (and their informal caregivers); persons with disabilities; children with chronic health needs; and communities defined by sexual orientation, ethnicity and race (including First Nations). Projects also highlight the crucial role of informal and mostly unpaid caregivers, family, friends and neighbors, in supporting the wellbeing, quality of life, and independence of persons of all ages who cannot manage on their own.
This page provides links to BoC findings and reports within the public domain including those from projects completed in 11 of Ontario’s 14 LHINs.
Reports
Housing Options for People Living With Dementia
Ed Starr, Jodi Ball, Johanna Hashim, A. Paul Williams, Frances Morton-Chang, Natalie Warrick and Doug Synder. Submitted to the Canada Mortgage and Housing Corporation (CMHC), 2015
Erie St. Clair Balance of Care Project: Windsor-Essex Final Report
A. Paul Williams, Allie Peckham, David Rudoler, Tommy Tam and Jillian Watkins. Submitted to Erie St. Clair Local Health Integration Network, May 2014
Caregiver Framework for Children with Medical Complexity Phase 3 Evaluation: Final Report
A. Paul Williams, Karen Spalding, Allie Peckham, David Rudoler, Tommy Tam and Jillian Watkins. Submitted to Hospital for Sick Children, May 2014
Evaluation of the Alzheimer Society of Toronto iPod Project
A. Paul Williams, Allie Peckham, David Rudoler, Tommy Tam and Jillian Watkins. Submitted to the Alzheimer Society of Toronto, March 2014
Caregiver Support Project: Formative Evaluation, Final Report
A. Paul Williams, Allie Peckham, David Rudoler, Tommy Tam and Jillian Watkins. Submitted to the Alzheimer Society of Toronto, April 2013
Formative Evaluation of the Counselling Program at the Alzheimer Society of Toronto
A. Paul Williams, Allie Peckham, David Rudoler, Tommy Tam and Jillian Watkins. Submitted to the Alzheimer Society of Toronto, April 2013
Leading System Integration for Adults with Physical Disabilities: A Strategic Evaluation of Bellwoods’ Community Connect Program
Fern Teplitsky, A. Paul Williams, Allie Peckham, David Rudoler and Jillian Watkins. Submitted to Bellwoods Centre for Community Living, May 2011
The North West Balance of Care Project II: Supportive Housing
A. Paul Williams, Kerry Kuluski and Jillian Watkins. Submitted to the North West Community Care Access Centre and North West Local Health Integration Network, July 2010
Formal and Informal Care for Older Persons: Assessing the Balance in Ontario
A. Paul Williams, Allie Peckham, Kerry Kuluski, Robin Montgomery, Frances Morton and Jillian Watkins. Submitted to the Research Division, Ontario Ministry of Health and Long-Term Care, July 2010
Balancing Care for Supportive Housing
Janet Lum, A. Paul Williams, Jennifer Sladek and Alvin Ying. Prepared by the Balance of Care Research Group, University of Toronto, May 2010
Mapping the State of the Art: Integrating Care for Vulnerable Older Populations
A. Paul Williams, Raisa Deber, Janet Lum, Robin Montgomery, Allie Peckham, Kerry Kuluski, Jillian Watkins, Frances Morton-Chang, Alex Williams, Alvin Ying and Lynn Zhu. Submitted to the Ministry of Health and Long-Term Care; Canadian Institutes for Health Research, Fall 2009
The Champlain Balance of Care Project: Final Report
A. Paul Williams and Jillian Watkins. Submitted to the Regional Geriatric Program of Eastern Ontario, the Champlain Community Care Access Centre, the Champlain Local Health Integration Network, the Regional Geriatric Advisory Committee and the Senior’s Impact Council of the United Way/Centraide, Ottawa, October 2009
Victorian Order of Nurses Canada SMILE Program Evaluation Report
Balance of Care Research and Evaluation Group and SHS Consulting. Submitted to the Victorian Order of Nurses Canada and South East Local Health Integration Network, July 2015
Articles
Caring for Caregivers: Facing Up To Tough Challenges
A. Paul Williams, Allie Peckham, Jillian Watkins, Natalie Warrick, Tommy Tam, David Rudoler and Karen Spalding
Healthcare Quarterly, 17(3) 2014: 20-23
Caring for Caregivers of High-Needs Children
Allie Peckham, Karen Spalding, Jillian Watkins, Cindy Bruce-Barrett, Marta Grasic and A. Paul Williams
Healthcare Quarterly, 17(3) 2014: 30-35
Caring for Caregivers of High Needs Older Persons
Natalie Warrick, Allie Peckham, Jillian Watkins, Marija Padjen and A. Paul Williams
Healthcare Quarterly, 17(3) 2014: 24-29
Balancing Formal and Informal Care for Older Persons: How Case Managers Respond
Allie Peckham, A. Paul Williams and Sheila Neysmith
Canadian Journal on Aging, 33(2) 2014: 123-136
Homecare or Long-term Care? Setting the Balance of Care in Urban and Rural Northwestern Ontario, Canada
Kerry Kuluski, A. Paul Williams, Whitney Berta and Audrey Laporte
Health & Social Care in the Community, 20(4) 2012: 438-448
The Role of Home and Community Based Care Capacity in Shaping Risk of Placement in Urban and Rural Regions
Kerry Kuluski, A. Paul Williams, Whitney Berta and Audrey Laporte
Healthcare Policy, 8(1) 2012: 92-105
Chicken Little? Why the Healthcare Sky Does Not Have to Fall
A. Paul Williams and Janet M. Lum
HealthcarePapers, 11(1) 2011: 52-58
Aging at Home: Integrating Community-Based Care for Older Persons
A. Paul Williams, Janet M. Lum, Raisa Deber, Robin Montgomery, Kerry Kuluski, Allie Peckham, Jillian Watkins, Alex Williams, Alvin Ying and Lynn Zhu
HealthcarePapers, 10(1) 2009: 8-21
Aging at Home: The Authors Respond
A. Paul Williams, Janet M. Lum, Raisa Deber, Robin Montgomery, Kerry Kuluski, Allie Peckham, Jillian Watkins, Alex Williams, Alvin Ying and Lynn Zhu
HealthcarePapers, 10(1) 2009: 79-83
Balancing Institutional and Community-Based Care: Why Some Older Persons Can Age Successfully at Home While Others Require Residential Long-Term Care
A. Paul Williams, David Challis, Raisa Deber, Jillian Watkins, Kerry Kuluski, Janet M. Lum and Stacey Daub
Longwoods Review, 7(1) 2009: 95-105
Strategic purchasing in home and community care across Canada: Coming to grips with “what” to purchase
A. Paul Williams
Healthcare Papers, 8(sp) 2007: 93-103
Thesis
Tipping Points to Institutional Care for Persons Living with Dementia: Analyzing the Policy Trajectory in Ontario
Morton-Chang, Frances Margaret. PhD Thesis, Institute for Health Policy, Management and Evaluation, University of Toronto, 2015.
CAREGIVER SUPPORT
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Caring for Caregivers: Challenging the Assumptions
A. Paul Williams, Allie Peckham, Kerry Kuluski, Janet Lum, Natalie Warrick, Karen Spalding, Tommy Tam, Cindy Bruce-Barrett, Marta Grasic and Jennifer Im
HealthcarePapers, 15(1) 2015: 8-21
Caring for Caregivers: Bridging the Care Gap
A. Paul Williams, Allie Peckham, Kerry Kuluski, Janet Lum and Frances Morton-Chang
HealthcarePapers, 15(1) 2015: 62-66
Because This is the Rainy Day: A Discussion Paper on Home Care and Informal Caregiving for Seniors with Chronic Health Conditions
The Change Foundation, February 2011
Caring-About-Caregivers: Caregiving for the Future of Ontario
Adalsteinn Brown. Published by the Ontario Ministry of Health and Long-Term Care, November 2009
Who Cares and How Much? The Imputed Economic Contribution to the Canadian Healthcare System of Middle-Aged and Older Unpaid Caregivers Providing Care to The Elderly
Marcus J. Hollander, Guiping Liu and Neena L. Chappell. Healthcare Quarterly, 12(2) 2009: 42-49
CHRONIC DISEASE MANAGEMENT
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Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model
Mary Stuart, Francesco Benvenut, Richard Macko, Antonio Taviani, Lucianna Segenni, Federico Mayer, John D. Sorkin, Steven J. Stanhope, Velio Macellari and Michael Weinrich. Neurorehabilitation and Neural Repair, 23(7) 2009: 726-734
Community Exercise: A Vital Component to Healthy Aging
Mary Stuart, Sarah Chard, Francesco Benvenuti and Sharon Steinwach. HealthcarePapers, 10(1) 2009: 23-28
Exercise for Chronic Stroke Survivors: A Policy Perspective
Mary Stuart, Sarah Chard, and Suzanna Roettger. Journal of Rehabilitation Research and Development, 45(2) 2008: 329-336
DEMENTIA
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Addressing Dementia: The OECD Response
Organisation for Economic Co-operation and Development, 2013
Assistive Technology as a Means of Supporting People with Dementia: A Review
Steve Bonner and Tahir Idris. Housing Learning and Improvement Network, July 2012
Dementia Evidence Brief: Waterloo Wellington Local Health Integration Network
Alzheimer Society Ontario, July 2012
Dementia in Canada: A National Strategy for Dementia-Friendly Communities
Standing Senate Committee on Social Affairs, Science and Technology, November 2016
Dementia: Supporting People with Dementia and Their Carers in Health and Social Care
National Institute for Health and Care Excellence, November 2006
Developing Ontario's Dementia Strategy: A Discussion Paper
Ministry of Health and Long-Term Care, September 2016
Guideline for Integrated Dementia Care
Netherlands Ministry of Health, Welfare and Sport; Zorgverzekeraas Nederland; Alzheimer Nederland, ActiZ, May 2009
INTEGRATED CARE
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INTERLINKS Reports
Prevention and Rehabilitation Within Long-Term Care Across Europe
Susanne Kümpers, Kerry Allen, Lorna Campbell, Anja Dieterich, Jon Glasby, Georgios Kagialaris, Tasos Mastroyiannakis, Tatjana Pokrajac, Georg Ruppe, Eva Turk, Roelf van der Veen and Lis Wagner. May 2010.
Informal Care in the Long-Term Care System
Judy Triantafillou, Michel Naiditch, Kvetoslava Repkova, Karin Stiehr, Stephanie Carretero, Thomas Emilsson, Patrizia Di Santo, Rastislav Bednarik, Lydia Brichtova, Francesca Ceruzzi, Laura Cordero, Tasos Mastroyiannakis, Maite Ferrando, Karl Mingot, Joachim Ritter and Diamantoula Vlantoni. May 2010.
Quality Management and Quality Assurance in Long-Term Care
Henk Nies, Kai Leichsenring, Roelf van der Veen, Ricardo Rodrigues, Pierre Gobet, Laura Holdsworth, Sabina Mak, Elisabeth Hirsch Durrett, Marion Repetti, Michel Naiditch, Teija Hammar, Hennamari Mikkola, Harriet Finne-Soveri, Timo Hujanen, Stephanie Carretero, Laura Cordero, Maite Ferrando, Thomas Emilsson, Gunnar Ljunggren, Patrizia Di Santo, Francesca Ceruzzi and Eva Turk. May 2010.
Governance and Finance of Long-Term Care Across Europe
Kerry Allen, Rastislav Bednárik, Lorna Campbell, Anja Dieterich, Elisabeth Hirsch Durrett, Thomas Emilsson, Jon Glasby, Pierre Gobet, Georgios Kagialaris, Jan Klavus, Susanne Kümpers, Kai Leichsenring, Gunnar Ljunggren, Tasos Mastroyiannaki, Satu Meriläinen, Michel Naiditch, Henk Nies, Marion Repetti, Kvetoslava Repkova, Ricardo Rodrigues, Karin Stiehr, Roelf van der Veen, Lis Wagner and Barbara Weigl. September 2011
Integrated Care for Older People in Europe - Latest Trends and Perceptions
Kai Leichsenring. International Journal of Integrated Care, 12(30 January) 2012: 1-4.
Mapping the State of the Art: Integrating Care for Vulnerable Older Populations
A. Paul Williams, Raisa Deber, Janet Lum, Robin Montgomery, Allie Peckham, Kerry Kuluski, Jillian Watkins, Frances Morton-Chang, Alex Williams, Alvin Ying and Lynn Zhu. Prepared for: Ministry of Health and Long-Term Care; Canadian Institutes for Health Research. Fall 2009
Increasing Value for Money in the Canadian Healthcare System: New Findings and the Case for Integrated Care for Seniors
Marcus J. Hollander, Jo Ann Miller, Margaret MacAdam, Neena Chappell and David Pedlar. Healthcare Quarterly, 12(1) 2009: 38-47
All Together Now: A Conceptual Exploration of Integrated Care
Dennis Kodner. Healthcare Quarterly, 13(Special Issue) 2009: 6-15
Understanding LHINs: A Review of the Health System Integration Act and the Integrated Health Services
Komal Bhasin MSW, MHSC (HA), CHE; and A. Paul Williams, PhD., Professor, Department of Health Policy, Management and Evaluation, University of Toronto and CRNCC Co-Chair.
Prepared for the Canadian Reasearch Network for Care in the Community (CRNCC) and the Ontario Community Support Association (OCSA). May 2007
Integrated Care: Meaning, Logic, Applications and Implications - A Discussion Paper
Dennis L. Kodner and Cor Spreeuwenberg. Journal of Integrated Care, 2, 14 November 2002: 1-6
Fully Integrated Care for Frail Elderly: Two American Models
Dennis L. Kodner and Corinne Kay Kyriacou. Journal of Integrated Care, 1, 1 November 2000: 1-19
PRISMA Reports
System Integration in Quebec, the Prisma Project
Margaret McAdam and Stephanie MacKenzie. Health Policy Monitor, 12, 2008.
Synthèse des connaissances sur les conditions de mise en œuvre des réseaux de services intégrés aux personnes âgées
Léo-Roch Poirier, Sarah Descôteaux and Jean-Frédéric Levesque. Published by Institut national de santé publique du Québec, February 2014.
Integrating Care for Older People with Complex Needs: Key Insights and Lessons from a Seven-country Cross-case Analysis
Walter P. Wodchis, Anna Dixon, Geoff M. Anderson and Nick Goodwin. International Journal of Integrated Care, 15, 23 September 2015.
PRISMA: Program of Research to Integrate the Services for the Maintenance of Autonomy. A System-level Integration model in Quebec
Margaret McAdam. International Journal of Integrated Care, 15, 23 September 2015.
Successfully Integrating Aged Care Services: A Review of the Evidence and Tools Emerging from a Long-term Care Program
Michael J. Stewart, Andrew Georgiou and Johanna I. Westbrook. International Journal of Integrated Care, 13, 22 February 2013.
HEALTH HUMAN RESOURCES
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The Community Support Service Health Human Resource Report: 2010 Salary Survey
Ontario Community Support Association. 2010
HEALTH CARE
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Evaluation of Healthcare Services: Asking the Right Questions to Develop New Policy and Program-Relevant Knowledge for Decison-Making
Marcus J. Hollander, Jo Ann Miller and Helena Kadlec. Healthcare Quarterly, 10(4) 2010: 40-47
Time for a Paradigm Shift: Managing Smarter by Moving from Data and Information to Knowledge and Wisdom in Healthcare Decision-Making
Marcus J. Hollander, Christopher Corbett and Paul Pallan. Healthcare Quarterly, 13(2) 2010: 49-54
Providing Care and Support for an Aging Population: Briefing Notes on Key Policy Issues
Marcus J. Hollander, Neena L. Chappell, Michael J. Prince and Evelyn Shapiro. Healthcare Quarterly, 10(3) 2007: 34-45
Building on Values – The Future of Health Care in Canada
Final Report of the Commission on the Future of Health Care in Canada. Commissioner: Roy J. Romanow, Q.C. November 2002
The Health of Canadians – The Federal Role
Final Report - Volume Six: Recommendations for Reform. By The Standing Senate Committee on Social Affairs, Science and Technology Chair: The Honourable Michael J.L. Kirby, Deputy Chair: The Honourable Marjory LeBreton. October 2002
INTERNATIONAL CASE STUDIES
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An Asian Flavour for Medicare: Learning from Experiments in Japan, Korea and Taiwan
Ito Peng and James Tiessen. Macdonald-Laurier Institute Series: Medicare Mid-Life Crises 5. April 2015.
MENTAL HEALTH
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Respect, Recovery, Resilience: Recommendations for Ontario's Mental Health and Addictions Strategy
Minister's Advisory Group on the 10-Year Mental Health and Addictions Strategy. December 2010
Out of the Shadows at Last - Transforming Mental Health, Mental Illness and Addiction Services in Canada
Final Report of The Standing Senate Committee On Social Affairs, Science And Technology
The Honourable Michael J.L.Kirby, Chair, The Honourable Wilbert Joseph Keon, Deputy Chair. May 2006
PEDIATRIC HOME CARE
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Prescriptions for Pediatric Home Care: Analyzing the Impact of the Shift from Hospital to Home and Community on Children and Families
A. Paul Williams, Karen Spalding, Raisa B. Deber and Patricia McKeever. Funded by the Hospital for Sick Children Foundation. March 2005
PERFORMANCE MEASUREMENT
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Community Care Common Standards Guide
Australian Government Department of Health and Ageing. October 2010
Performance Measurement Project: South West Community Support Services - Final Report
Roland Kriening. March 2009
Quality Framework Responsible Care: Nursing Care and Home Care
Steering Committee Responsible Care. May 2008
SEXUALITY AND INTIMACY
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Sexuality and Access Project: Survey Summary
Cory Silverberg and Fran Odette. Prepared for Springtide Resources and funded by the Ontario Trillium Foundation. 2011
Supporting Sexual Health and Intimacy in Care Facilities: Guidelines for Supporting Adults Living in Long-Term Care Facilities and Group Homes in British Columbia, Canada
Sally Green, Marie Carlson, Gerrit Clements, Bethan Everett and Jenny Young. Published by Vancouver Coastal Health Authority and funded in part by the Public Health Agency of Canada. September 2009
Canadian Guidelines for Sexual Health Education
Published by the Public Health Agency of Canada. 2003.
SUPPORTIVE HOUSING
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Balancing Care for Supportive Housing
Janet Lum, A. Paul Williams, Jennifer Sladek and Alvin Ying. Prepared by the Balance of Care Research Group, University of Toronto, May 2010
National Evaluation of the Retirement Villages Care Project
Cathy Hales, Lydia Ross and Claire Ryan. August 2006
A Model for Improved Home Support in Vancouver
Vancouver Coastal Health. July 2006
Saskatchewan Health, Community Care Branch Home Care Program Review - Final Report
Prepared by Hollander Analytical Services Ltd. February 2006
Discussion on CHOICE Model from Hollander Analytical Services Ltd
Home care program review: Final report. Saskatoon: Saskatchewan Health, Community Care Branch. 2006
Yes, in my back yard ~ A guide for Ontario's supportive housing providers HomeComing Community Choice Coalition, Revised Edition 2005
When Home is Community: Community Support Services and the Well-Being of Seniors in Supportive and Social Housing
Janet M. Lum, Simonne Ruff and A. Paul Williams. A Research Initiative of Ryerson University , Neighbourhood
Link/Senior Link and the University of Toronto, Funded by United Way of Greater Toronto. April 2005
Reports from Canada Mortgage and Housing Corporation (CMHC):
