This commentary addresses several issues raised by Chappell and Hollander in their review of policy issues that should be addressed to improve care for the elderly in Canada. First, the author takes some issue with the suggestion that the continuing care system needs to be re-validated. The data seem to indicate that the issue is not re-validation of the system but, rather, operational reform of the current system. Thus, the recommendation to focus on improving integrated care for seniors, which is a process measure, is a very timely one. Then the author raises the question of recommending a value-for-money approach to care of the elderly. Although fraught with problems and a lack of data, increasing numbers of researchers and others are suggesting that there is a need to question how we are spending scarce resources. A value-for-money policy would contribute evidence about the most effective use of services for older people.
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