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Patient Days in Alternate Level of Care (Percentage)

This measure provides the proportion of days a patient was assigned to the alternate level of care (ALC) patient service. ALC patients are those who no longer need acute care services but continue to occupy an acute care bed or use acute care resources while waiting to be discharged to a more appropriate care setting.

The proportion of days a patient was assigned to the ALC patient service in a hospital.
Given the implications for patient care being delivered in an appropriate setting and the potential impact on resource use, a small number is desirable.
 

Data updated:
Data availability: (fiscal years)
Geographic coverage
All provinces/territories except Quebec
Reporting level
Province/Territory, Region, Facility
Calculation

The total number of days spent in ALC divided by the total length of hospital stay, multiplied by 100

Denominator

Sum of the total days spent in hospital (total length of stay [LOS]) 

Numerator

Sum of the total ALC LOS days

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Name

Patient Days in Alternate Level of Care (Percentage)

Description

The proportion of days a patient was assigned to the alternate level of care (ALC) patient service.

ALC patients are those who no longer need acute care services but continue to occupy an acute care bed or use acute care resources while waiting to be discharged to a more appropriate care setting.
 

Rationale

There is growing concern that providing ALC services in an acute care hospital is not optimum for patients who are ready to be discharged but must remain in hospital until they can be discharged to an appropriate setting. Long LOS for patients in ALC service can have a negative impact on the efficiency and resource use of hospitals; an example is long waits in the emergency department pending the availability of an inpatient bed. This measure indicates the total days where patients were designated as being on the ALC service as a proportion of the total patient days for the hospital. 

The availability of out-of-hospital supporting health services (such as home care and long-term residential care) is often a significant factor in the delay to discharge, resulting in longer LOS in ALC service.
This measure may help hospital administrators monitor the LOS in ALC service and collaborate with other sectors of the health care system to improve the ALC patient flow.
 

Interpretation

The proportion of days a patient was assigned to the ALC patient service in a hospital.
Given the implications for patient care being delivered in an appropriate setting and the potential impact on resource use, a small number is desirable.
 

Available Data Years

(fiscal years)

Geographic Coverage

  • All provinces/territories except Quebec

Reporting Level/Disaggregation

  • Province/Territory
  • Region
  • Facility

Indicator Results

Your Health System (YHS): In Depth
Your Health System (YHS): Insight
 

Update Frequency

Annual update in YHS: In Depth
Monthly update in YHS: Insight

Latest Results Update Date

Description

The total number of days spent in ALC divided by the total length of hospital stay, multiplied by 100

Type of Measurement

Percentage or proportion

Denominator

Description:

Sum of the total days spent in hospital (total length of stay [LOS]) 

Inclusions:

Records with a valid LOS

Exclusions:

  • Stillborn and cadaveric donor records
  • Records with an invalid LOS
  • Records from Quebec, due to a different definition of ALC service
     

Numerator

Description:

Sum of the total ALC LOS days

Exclusions:

  • Stillborn and cadaveric donor records
  • Records with an invalid LOS
  • Records from Quebec, due to a different definition of ALC service
     

Geographic Assignment

Place of service

Data Sources

  • DAD

Caveats and Limitations

ALC service varies greatly among hospitals and patient populations. This measure is not intended to be comparable; rather, it is to be used by hospitals and regions internally to better understand their profile information and monitor their ALC patient population.

References

Not applicable

How to cite:

Canadian Institute for Health Information. Patient Days in Alternate Level of Care (Percentage). Accessed April 28, 2025.