Design: This research takes the form of a critical policy analysis of the interaction of the context, process, and content of policy proposals in home care.

Population, Sample, Setting, Years: The unit of analysis for the study is the sub-system of home care within a regional health system in one Canadian province. The period of data collection was June, 2000 - 2001.

Concept or Variables: The conceptual approach to this study is derived from the tenets of critical theory and their application to the analysis of health policy. Underpinning the study was the perspective that the values and principles of primary health care constitute progressive public policy.

Method(s): The method of study includes thematic and comparative analyses of perspectives derived from interviews with decision-makers, health care providers, and public advocates, and from policy documents.

Findings: Findings of the study revealed that the delivery of home care in one health region was evolving in the direction of a medical model of care. Tensions in values of efficiency, equity, choice, and responsibility underpin the policy issues and the perspectives of the different policy and organizational actors: decision-makers, health care providers, public advocates, and program managers. The content and process of policy in home care interacts in important ways with political, economic, social, and historical contexts.

Conclusions: Conclusions relate to transforming home care policy and the utility of a critical theory approach to health policy analysis.

Implications: Nursing is positioned to contribute to the development of policy science and the fulfillment of policy advocacy roles in home care and other key areas.

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