Skip to main content

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

Comments

Popular posts from this blog

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2. 

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medavie Blue Cross with 1,900 employees.  It now a