Health and Social Care in the Community 15(1), 1–7 doi: 10.1111/j.1365-2524.2006.00645.x © 2006 The Authors, Journal compilation © 2006 Blackwell Publishing Ltd 1 Abstract The need for home care will probably continue to increase over the next decade as one response to innovative health practices designed to help people receive services at home instead of in institutions. However, there are no data for determining whether home-care programmes can meet user needs. The objectives of the present study were to describe the functional autonomy profile of the users of public home-care programmes in Québec, Canada, and to compare the level of adequacy between required and provided services in public home-care programmes for older adults with disabilities. This study was based on a cross-sectional design from September to December 2002. The population studied consisted of all users of public home-care services in one administrative region in the province of Québec over this 3-month period. Each user was assessed with the Functional Autonomy Measurement System (SMAF) and then classified into one of the 14 Iso-SMAF profiles. The total number of hours of care required was determined using the median number of hours of nursing care, personal care and support services associated with each profile. For the sake of comparison with the services required, the services provided were calculated from an administrative databank that included statistics of the time spent by health professionals on caring for home-care users. The ratio of hours of services provided to the number of hours of services required by home-care users highlights a discrepancy between the services provided and user needs. The results of this study show the feasibility of describing users of public home-care programmes and the adequacy of services provided in relation to user needs. Based on these results, public home-care programmes in the province of Québec appear to be under-funded. Keywords: case mix, classification, elderly, functional autonomy, health economics, health policy, home care, needs assessment Accepted for publication 31 March 2006 Blackwell Publishing Ltd Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users? M. Tousignant PT PhD 1,2 , N. Dubuc RN PhD 1,2 , R. Hébert MD MPhil 1,2 and C. Coulombe 1 1 Research Center on Aging, Sherbrooke Geriatric University Institute, Sherbrooke and 2 Faculty of Medicine, University of Sherbrooke, Sherbrooke, Québec, Canada Correspondence M. Tousignant PT PhD Research Center on Aging Sherbrooke Geriatric University Institute 1036 Belvédère Sud Sherbrooke Québec J1H 4C4 Canada E-mail: michel.tousignant@usherbooke.ca Introduction The public home-care programme figures prominently in the continuum of healthcare services in Canada. Public home care has been well established in Québec for more than 30 years under local agencies known as local community service centres (CLSCs). For the delivery of long-term care and services, CLSCs use a provider model in which services are arranged and provided by CLSC staff, and to a lesser extent, a self-managed care model is available for specific clienteles. Home-care programmes can provide three types of services: (1) post-acute recovery services; (2) maintenance for functionally disabled or frail individuals who need help to remain at home; and (3) palliative care. The goal