The Challenge

In Canada, patients who have been approved for discharge by their physician, but are awaiting placement in a more appropriate setting, receive the designation Alternate Level of Care (ALC). Keeping patients in hospital when their needs would be better met elsewhere represents poor quality care. When hospital beds are in short supply, ALC service use may also have downstream consequences for emergency room admissions, facility transfers, and even elective surgeries, undermining efficiency of the health care system.

Our Approach

The objectives of this project were to describe the current state of ALC service use in BC, understand what factors shape variation across hospitals and regions, and explore the potential for interventions targeting regions with high ALC service use to improve system quality and efficiency.  Our project leader, Dr. Ruth Laverge, analyzed data from the Canadian Institute for Health Information and the BC Ministry of Health, and identified significant variations in ALC length of stay among hospitals in BC.

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