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Evidence to Improve Care

Specialized Community-Based Care


Ontario Health Technology Advisory Committee Recommendations

  • Access to specialized community-based care (intermediate care) should be made available for patients with chronic diseases, and whose diseases are becoming uncontrollable despite primary care

  • Recognizing that primary care is the optimal way of treating and coordinating the care of patients with co-morbidities, patients should be returned to primary care for further follow-up with the revised treatment plan once they have been stabilized through intermediate care access

Read the full OHTAC Recommendation Report



Specialized community-based care, often referred to as intermediate care, is care provided to people with long-term (chronic) illnesses who need more than basic care, but do not require intensive care. There is convincing evidence specialized community-based care improves outcomes in patients with heart failure, chronic obstructive pulmonary disease (COPD) and diabetes.


Health Quality Ontario Reviews Specialized Community-Based Care

Health Quality Ontario conducted a series of evidence reviews of specialized community-based care to:

  • Review the literature on specialized community-based care for chronic diseases

  • Gather the evidence from previous analyses of specialized community-based care for chronic obstructive pulmonary disease, heart failure, diabetes and chronic wounds

  • Examine the role of intermediate care within family practice

  • Specialized Community-Based Care: An Evidence-Based Analysis (PDF)
    November 2012

    Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis (PDF)
    March 2012


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    The Ministry of Health and Long-Term Care endorses these recommendations.

    The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with these recommendations and encourages health service providers to examine opportunities to implement specialized community-based care. The Ministry is working with system partners to examine implementation opportunities.




    Health Technology Assessment at Health Quality Ontario

    As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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