Models of Publicly Funded Home Care for Community-Dwelling Older Adults Across Six High-Income Health Systems: A Scoping Review

As Canada’s population ages, demand for publicly funded home care is increasing, placing growing pressure on health and social care systems. Home care plays a critical role in supporting ageing in place; however, it is organized through diverse models of funding, governance, and service delivery across high-income countries. In Canada, a recurring concern among clients and family caregivers is the mismatch between available human resources and care needs, contributing to dissatisfaction and challenges related to care quality, continuity, and integration. The purpose of this scoping review is to identify and characterize models of publicly funded home care for community-dwelling older adults in Canada and in comparable health systems, including England (United Kingdom), Australia, New Zealand, Sweden, and Denmark. The review will map key model characteristics and synthesize available evaluation evidence related to quality of care, patient and family satisfaction, workforce considerations, integration with health and social care systems, and equity-relevant factors. This scoping review will be conducted in accordance with JBI methodology and reported following PRISMA-ScR guidelines. MEDLINE, Embase, and CINAHL will be searched from 2005 onwards, alongside targeted grey literature searches. Eligible sources will include peer-reviewed and grey literature describing, analyzing, or evaluating publicly funded home care models in the included countries. Data will be extracted and synthesized using qualitative content analysis. An equity lens will be applied using the PROGRESS-Plus framework, and sex and gender reporting will be assessed using SAGER guidelines. Findings are expected to identify common strengths and challenges across models, gaps in evidence related to quality, integration, and equity, and areas where further evaluation and policy attention are needed.