Issue link: http://clhia.uberflip.com/i/354914
9 conjunction with a subsidy offered by governments to promote self-funding of long-term care. 3. PATIENT CENTERED APPROACH TO LONG-TERM CARE Patients must be allowed to grow old with dignity and honour, which means that individuals must have choice and the power to make decisions about their own living arrangements and care. Patient centered care is designed to meet the needs of the individual receiving care and treatment rather than having the patient fit into pre-existing institutional systems. This type of care sees patients as equal partners in planning, developing and assessing care to make sure it is most appropriate for their needs. It involves putting patients and their families at the heart of decisions. In this regard, patient centered care is respectful of, and responsive to, the preferences, needs and values of patients. Research demonstrates that patient centered care improves the patient care experience and creates value for services (i.e., better services for money spent). In recent years, strategies used in the U.S. and U.K. to improve overall healthcare quality, such as public reporting and financial incentives, have emerged as policy-level drivers for improving patient centered care. There have also been initiatives in the Canadian provinces, such as British Columbia, Alberta and Ontario, that focus on patient centered funding. In its 2009 policy paper on health care 22 , the CLHIA recommended that federal, provincial and territorial governments collaborate to take a patient centered approach to health care service delivery and funding to increase efficiencies and improve health outcomes for all Canadians. The CLHIA continues to recommend this approach, including for long-term care. A critical implication of this principle is that Canada must move away from primarily funding institutions and services. Wherever possible, funding should be directed to the individual, who then is able to decide which facility or which level of care along the continuum is most appropriate for them. There are some legitimate concerns about how to ensure that such funds are directed appropriately to long-term care, particularly for patients whose mental competency has started to decline. We would encourage all providers of long-term care funding to consider innovative approaches to address this concern such as having providers invoice the funders for services rendered (like an insurer would with any extended healthcare service). This allows the funding body (government, insurer, family, etc.) to have some degree of oversight over how the funds are being spent, while providing incentives for providers to compete and innovate for the benefit of patients. It should be noted that this represents a fundamental shift in how governments currently fund other forms of healthcare such as hospitals and existing long- term care facilities. Recommendations The CLHIA recommends that a patient centered approach form the core of Canada's approach to long-term care service delivery. Any funding of long-term care should be directed to individuals rather than funding institutions directly. 22 CLHIA Report on Health Care Policy: Towards a Sustainable, Accessible, Quality Public Health Care System. June 2009.