The Cost of Homecare Personal Support Worker Turnover

As demand for homecare services continues to rise, homecare worker retention remains a critical issue for the sector which impacts access to care and operational efficiency. To design evidence-based retention policies within a fiscally constrained context, it is important to understand the sector-specific costs of turnover. Using data from a large homecare provider organization in Ontario, Canada, we have developed the first known homecare Personal Support Workers (PSWs) cost of turnover estimate. We estimate a turnover cost of $22,000 (CAD 2024) per homecare PSW, based on an employer-level homecare-specific model. The primary driver of turnover costs was opportunity costs from reduced capacity; other more direct costs such as recruitment and training were smaller contributors. Decision-makers at both the organizational and broader health system level can use this estimate in considering the cost-benefit ratio and return on investment of interventions designed to promote the retention of homecare PSWs, such as enhanced training, benefits, and preceptorship programs.