Can we afford consumers choice in home care?

Carol L. McWilliam, Moira Stewart, Evelyn Vingilis, Catherine Ward-Griffin, Allan Donner, Karen Anderson, Jeffrey S Hoch, Peter Coyte, Gina Browne

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


As demands for home care escalate in a system concerned with cost containments, initiatives promoting client involvement in the management of their chronic illnesses and attendant services have attracted increasing attention. For longer term in-home care, varied approaches to case management reflect these trends. This article reports a study exploring the cost consequences of clients' choice of three approaches to case management within a single home care context. The first involved leaving the control of services and care to the system's case manager. The second option was to share this control in partnership with their in-home service providers. The third approach featured clients directing their own case management. Overall, the average costs per month of services for clients in the three groups did not differ significantly over 6 or more months. However, clients who chose direct involvement in their case management actually had significantly lower cost increases than clients with little control over their case management. While further investigation is needed, offering clients choice of involvement in their in-home case management may both lower costs and optimize clients' potential for involvement in their care.

Original languageEnglish (US)
Pages (from-to)171-178
Number of pages8
JournalCare Management Journals
Issue number4
StatePublished - 2007
Externally publishedYes


  • Case management
  • Client involvement
  • Consumer-driven costs
  • In-home service delivery

ASJC Scopus subject areas

  • Health Policy
  • Leadership and Management


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