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Aim to solve only the smallest part of the hospital crisis -- and you won't solve the bigger parts

For years, the province has emphasized the use of home care as the solution to the problem of hospital overloads and backlogs . Yet, even after using this approach for years, only a small minority of 'alternate level of care' (ALC) patients are actually waiting for home care (4.7%).

A much larger percentage (57%) are waiting for long term care.  But long term care is a service the province is determined not to expand very much.

Many other ALC hospital patients are waiting for a different sort of hospital bed than the one they are in.  Out of the 4,256 ALC patients in hospitals, up to about a thousand patients fall into this category.

While officials often talk as if ALC patients should not be in a hospital,  in reality, many more ALC hospital  patients are waiting for hospital care than are waiting for home care.

Until the announcement last Friday of funding for 221 hospital beds to relieve ER pressures, there was no sign that the Liberal government had any intention of working on the hospital bed portion of the solution to hospital overflows.

But even that (modest) change in direction will only just begin to reduce the 700 or so people in emergency rooms waiting for an acute care bed.   It will do nothing for the people already in a hospital bed who are waiting for rehabilitation care, or complex continuing care, or palliative care in the hospital.

So, despite all the government media releases, the government remains focused only on a small part of the ER / hospital overflow problem.  And so far, no political force has demanded a broader focus.

Consequently, there are few signs that hospital overflows (or LTC wait times) will end any time soon.


  1. In our area, Hamilton Niagara Halton Brant LHIN, have taken the Continuing out of Complex Continuing Care....thereby leaving only Complex Care (CC).

    They will cut the number of days a CC patient will be allowed to stay in the hospital using a variety of strategies. Patients will no longer be able to stay in hospital beds for long periods of time. It will be defined, and you can be sure the number of defined days allowed will gradually, but surely drop.
    Simultaneously patients at home will be discouraged to coming to the ER and patients in the ER will be discouraged from being admitted to the hospital.

    The LHIN is counting on these strategies to enable them to be able to cut a number of hospital beds by April 2012, without the addition of new LTC beds.

    The LHIN will tell you they are not cutting acute hospital beds, but be aware these beds in 2008 had been acute beds and they were redesignated to CCC beds and now will be cut.

    So it's sort of like a game of smoke and mirrors, or should I say musical chairs. When the music stops they cut another bed and see which patient gets left out.

    Pat Scholfield


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