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Informal caregiving is seen as a low-cost substitute for care provided by health care professionals. However, caregiving is known to negatively impact caregivers’ health and, subsequently, their health care use and costs. This could potentially offset the caregivers’ contributions to the health care system.We examined the impact of caregiving on costs associated with caregivers’ use of publicly funded health care services in Ontario, Canada, in comparison with non-caregivers.We included Ontarians who participated in the Canadian Community Health Survey-Healthy Aging Supplement Survey of 2008/09 and linked responses to health care administrative databases. A difference-in-differences design was used to capture differences in caregivers’ and non-caregivers’ total health care costs 1 and 2 years before and after caregiving start date. Generalized Linear Models were used to model the total health care costs.The sample size was 4275 with 1265 caregivers and 3010 non-caregivers. We found that while health care utilization increased over time, it increased by a lesser amount for caregivers than non-caregivers. Adjusted total health care costs for caregivers were 11.32% (SE = 0.05, ρ = 0.02) lower than non-caregivers 2 years into caregiving.Our study reveals a critical gap in policy, practice, and research driven by a lack of routine data collection and caregiver identification. It also highlights the need for additional longitudinal research focusing on caregivers’ objective health. [ABSTRACT FROM AUTHOR]

Introduction: East Toronto Health Partners (ETHP) is implementing a new integrated care model (ICM). ETHP is comprised of 50+ health and social organizations in East Toronto, with a leadership council consisting of patient/caregivers and six anchor organizations representing the continuum of care. ETHP is co-creating an IC model in which hospital, primary care, community providers and patients and families work together as one coordinated team in order to improve population health, patient and provider experience, and value for money (Quadruple Aim). Aims Objectives Theory or Methods: The aim is to create a learning health system within ETHP by embedding rapid cycles of evaluation to support learning, knowledge transfer, and decision making for scale and spread of ICM. A developmental evaluation (DE) approach is employed to achieve this goal. The priority population includes seniors with chronic care needs and their caregivers, and individuals with mental health challenges and substance use issues. ETHP's mandate is to expand the model's scope and coverage to cover the entire population of East Toronto. DE started in the fall of 2020 and is set up for 2 years. Highlights or Results or Key Findings: In our year 1 of DE, an evaluation steering committee including two patient partners was created to provide advice on the ongoing evaluations. To build capacity, evaluation workshops are being held focusing on evaluation types, developing logic models, and measurement. An early implemented ETHP's intervention, winter Surge initiative, was chosen to be evaluated at the project level (total of 15 projects). An evaluation template was developed for use across projects. The embed researcher worked closely with the project leads to develop logic models and choose appropriate measures. Projects used quantitative and qualitative methods to analyze their data. Main findings are: a) significant investment in knowledge-building around choosing appropriate metrics at the project-level is needed; b) system-level identified through the evaluation (e.g. primary care attachment) needs to be collaboratively addressed at the ETHP-level; c) evaluation processes need to be refined to meet the needs of the teams. Conclusions: ETHP is using DE to create a more integrated system of care for residents and providers across East Toronto. In its early stages, DE has focused on building internal evaluation capacity for internal teams to engage in ongoing evaluation activities creating a community of practice. Implications for applicability/transferability sustainability and limitations: By embedding rapid cycles of evaluation, ETHP aims to support strategic expansion of integrated models of care across its entire population. The focus on building internal evaluation capacity and an evaluation community of practice ensures sustainability. [ABSTRACT FROM AUTHOR]