Analysis of factors affecting demand for rehabilitation services in Ontario, Canada: a health-policy perspective

Abstract

Demand for health services tends to outstrip supply in an environment of economic scarcity.

Purpose: In this research, we first explore factors affecting demand for rehabilitation services in Canada's most populous province of Ontario; we then interpret these findings and discuss their implications for future demand.

Methods: Consistent with health-policy case-study methodology, we triangulated primary and secondary data sources (42 key-informant interviews and review of publicly available documents, respectively).

Results: Demand for rehabilitation seems to be rising quickly across Ontario's continuum of care, and informants identified four primary factors: (1) overall population growth along with an increasingly large cohort aged 65 years or older; (2) increasing rates of chronic and complex conditions, along with changes in hospital discharge patterns; (3) increasing public expectations; and (4) advances in treatment and management of diseases and condition.

Conclusions: Although demand may be rising, access to rehabilitation is now based more on eligibility than on demand alone. The presence of increasing demand does not ensure that there is, or will be, sufficient financial or human resources to meet such demand. This study signals the need to reflect on current policies regarding access, and highlights the need to consider the benefits of health-promotion and injury-prevention strategies in mediating demand.