The Untold Story of Being Designated an Alternate Level of Care Patient
Open accessAbstract
INTRODUCTION: Much of the research and policy reports on Alternate Level of Care (ALC) in Canada have focused on the impact ALC has on acute care services. To date, the experiences and opinions of those who must wait in hospital for alternate services have been largely absent from discussions. METHOD: A qualitative study was conducted with patients and families designated as ALC in one urban and two rural hospitals in Atlantic Canada. Data were analyzed using content analysis. RESULTS: Three themes emerged from the data: a perception of normalcy, being old but not sick and anticipating relocation to another facility. CONCLUSIONS: ALC is an important issue for patients and their families. Policy directives aimed at addressing the causes and impacts of ALC, identification and provision of appropriate supportive care in the community and sensitivity to the impact of ALC for individuals designated as ALC are needed.
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ALC patients and their families consistently describe poor care in qualitative studies, with anxiety regarding uncertainty of patient disposition and a perception of inconsistent care delivery.
“ALC patients and their families also consistently describe poor care in qualitative studies, with anxiety regarding the uncertainty of the patient disposition and a perception of inconsistent care delivery [8,9].”
From Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital (2022) · cites this paper as [9]
A few studies have used qualitative methods to examine the experience of ALC designation in small numbers of patients.
“A few studies have used qualitative methods to examine the experience of ALC designation in small numbers of patients [15, 16].”
Unnecessary and prolonged hospital stay contributes to patient and family stress and stigmatization.
“Finally, unnecessary and prolonged hospital stay contributes to patient and family stress and stigmatization [15, 16].”
Cites
Low mobility during hospitalization and functional decline in older adults
Zisberg, A., Shadmi, E., Sinoff, G., Gur‐Yaish, N., Srulovici, E., & Admi, H. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.03276.x · Cited by 393 · see citing works
Costa, A., & Hirdes, J. (2010) · Healthcare Policy | Politiques de Santé · doi:10.12927/hcpol.2010.21899 · Cited by 71 · cited 2× · see citing works
“Others have attempted to explore possible strategies to respond and reduce ALC within Canadian hospitals (Costa and Hirdes 2010; Ontario Hospital Association 2012; Sutherland and Crump 2011; Walker 2011).”
BackgroundResultCIHI Survey: Alternative Level of Care in Canada: A Summary
Walker, J., Morris, K., & Frood, J. (2009) · Healthcare Quarterly · doi:10.12927/hcq.2009.20674 · Cited by 26 · see citing works
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Bai, A. D., Dai, C., Srivastava, S., Smith, C. A., & Gill, S. S. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4760-3 · Cited by 79 · see citing works
“Finally, unnecessary and prolonged hospital stay contributes to patient and family stress and stigmatization [15, 16].”
BackgroundKuluski, K., Im, J., & McGeown, M. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2272-6 · Cited by 37 · see citing works
Lim Fat, G. J., Gopaul, A., Pananos, A. D., & Taabazuing, M.-M. (2022) · Geriatrics · doi:10.3390/geriatrics7040081 · Cited by 13 · see citing works
“ALC patients and their families eagerly await transition into LTC, where they foresee experiencing enhanced autonomy and daily structure [8,9].”
Background
- Authors
- McCloskey, R., Jarrett, P., & Stewart, C.
- Affiliations
- University of New Brunswick (CA)
- Dalhousie University (CA)
- Venue
- Healthcare Policy | Politiques de Santé
- Publisher
- Longwoods Publishing
- Published
- 2015-08-28
- Volume
- 11
- Issue
- 1
- Pages
- 76-89
- ISSN
- 1715-6572 (ISSN-L)
- 1715-6580
- PMC
- PMC4748367
- OpenAlex
- W1931688834
- Cited by
- 26
- References
- 3
- Citations by year
- 2025: 1 · 2024: 6 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 1
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Healthcare policy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
- Keywords
- alternate level of care, patient experience, family perspectives, patient waiting time, rural hospitals, hospital relocation, acute care services, Atlantic Canada
- MeSH terms
- Aged, 80 and over, Attitude to Health, Family, Female, Health Policy, Health Services Accessibility, Homes for the Aged, Hospitalization, Humans, Interviews as Topic, Long-Term Care, Male, New Brunswick, Nursing Homes, Patient Transfer, Patients, State Medicine, Time Factors, Waiting Lists, Frail Elderly, Qualitative Research, Standard of Care
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