Many "ALC" patients need hospital care.

A new report indicates that 18% of acute care beds were occupied by patients awaiting an alternate level of care (“ALC patients”).

ALC patients are waiting for a different level of care than what they are currently receiving in the hospital (e.g. a patient waiting for a complex continuing care bed who is in an acute care bed). While about half of these patients are awaiting long term care, the ALC designation does not necessarily mean that they should not be in hospital.

About 47% of the 2,812 ALC patients in acute care beds are waiting for a long term care bed. Most of the rest of the ALC patients in acute care beds are awaiting other sorts of hospital beds: rehabilitation (385 patients), complex continuing care (229 patients), convalescent care (118 patients), and palliative care (153 patients).

Surprisingly, only a relatively small number are awaiting home care (149 patients), assisted living or supportive housing (83 patients), or simply to go home (64 patients).

Another 1,807 ALC patients are in non-acute hospital beds (rehab beds, complex continuing care beds, mental health beds, etc.), bringing the total number of ALC patients in hospital to 4,679.

This represents 16% of hospital beds (acute and non-acute beds). This percent has been relatively constant since at least late 2007. The rate varies from 31% in the Northeast LHIN and 26% in the Northwest LHIN to 9% in the Mississauga Halton LHIN. Reportedly, a little over half (58%) of these patients are awaiting placement in long term care facilities.

Despite, the very high bed occupancy levels, hospital beds for ALC (or convalescing) patients are under direct threat of closure, even while there are no long term care, rehabilitation, convalescent, palliative, or complex continuing care hospital beds to take care of such patients.

Too often, this means forcing patients into inappropriate nursing homes too far from home and family, back to home without proper support (generally burdening unpaid women family members), and into for –profit retirement homes with insufficient services.

dallan@cupe.ca

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