An Intersectional Analysis of Client Satisfaction with Home Care in Canada
Date
2024
Authors
Oginni, Oyindamola
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Abstract
Home care is a priority for all Canadians but evidence from literature suggests that the home care system is generally prone to inequality. Client satisfaction is an integral component of home care, which measures the quality of home care. This study used the intersectional framework of gender and Indigenous identity to analyze client satisfaction with home care among home care recipients in Canada to determine the existence of inequalities in client satisfaction with home care.
The study design was based on secondary data analysis. The data source was the Canadian Community Health Survey 2021. The study population was respondents who received home care in the last 12 months. Intersectional strata (dummy variables) were created from gender and Indigenous identity. The outcome variable was client satisfaction (a binary variable with 0 “Not satisfied/Undecided” and 1 “Satisfied”). The control variables were age, income, sexual orientation, and language often spoken. Provincial/Territory variable was used for clustering the standard errors to account for heteroscedasticity across the clusters of observations. Quantitative analyses were conducted using frequencies, percentages, and multiple linear regression models. Statistical significance was set at p<0.05.
The non-Indigenous men and the non-Indigenous women together accounted for about 75 percent of the respondents, while the Indigenous men and the Indigenous women together accounted for about three percent of the respondents. Among the non-Indigenous men and the non-Indigenous women, 90.7 percent and 90.1 percent respectively expressed satisfaction with home care; meanwhile, 82.0 percent of Indigenous men and 88.8 percent of Indigenous women respectively expressed satisfaction with home care. Overall, 90.4 percent of the respondents were satisfied with home care. After controlling for age, income, sexual orientation, and languages, the regression analysis identified the Indigenous women and the non-Indigenous women as significantly (p<0.05) having a 9.6 percentage point and a 10.2 percentage point lower satisfaction with home care respectively, relative to “men with other identities”.
The study findings suggest the existence of inequalities in client satisfaction with home care, which is a barrier to the fundamental objectives of the program in Canada. The inequality in client satisfaction with home care identified in this study can be tackled in two ways. One approach involves community-based intervention, where experts lead strategy development and the community helps carry it out, gradually taking over responsibility. Alternatively, community development work emphasizes empowering community groups to identify and address disparities themselves, focusing on long-term sustainability and community empowerment. This approach prioritizes community involvement in resolving underlying issues.
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Keywords
client satisfaction, homecare, intersectionality, intersectional analysis, gender, Indigenous identity