Alternate-level-care-rate - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Alternate Level of Care (ALC) rate

Alternate Name

Percentage of inpatients days that beds were occupied by patients who could have been receiving care elsewhere

INDICATOR DESCRIPTION

Description

This indicator measures the total number of alternate level of care (ALC) days contributed by ALC patients within the specific reporting month/quarter using near-real time acute and post-acute ALC information and monthly bed census data. Alternate level of care (ALC) refers to those cases where a physician (or designated other) has indicated that a patient occupying an acute care hospital bed has finished the acute care phase of their treatment. A lower rate is better.

HQO Reporting tool/product

Public reporting, Quality Improvement Plans (QIPs)

Dimension

Efficient

Type

Process

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Rate per 100 inpatient days

Calculation Methods

This indicator is calculated as the numerator divided by the denominator times 100

Note that only those facilities (acute & post-acute) submitting both alternate level of care (ALC) data (to the Wait Time Information System (WTIS)) and Bed Census Summary (BCS) data (through the Health Database Web Portal) are included in the ALC rate calculation. Any master number that does not have inpatient days reported to the BCS for a given month/quarter will be excluded from reporting for that month/quarter.

Numerator (short description i.e. not inclusions/exclusions)

The total number of inpatient days designated as alternate level of care (ALC) in a given time period (i.e., monthly, quarterly, yearly)

Denominator (short description i.e. not inclusions/exclusions)

The total number of inpatient days in a given time period (i.e., monthly, quarterly, yearly)

Adjustment (risk, age/sex standardization)- generalized

None

Data Source

Bed Census Summary (BCS), Wait Time Information System (WTIS)

Data provided to HQO by

Cancer Care Ontario (CCO)

Reported Levels of comparability /stratifications (defined)

Region, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

The alternate level of care (ALC) rate indicator excludes facilities that are currently not reporting ALC data to the Wait Time Information System (WTIS). WTIS-ALC data are only available beginning in July 2011. The Bed Census Summary (BCS) has a three month reporting lag. Validation is required to ensure that specific bed types (in the BCS) correspond to those in WTIS. The information for both the numerator (WTIS) and denominator (BCS) are based on data that are available at a specific point in time. Therefore, rates calculated using these data are subject to change depending on when the calculations are made.

Comments Summary

This indicator looks at "inpatient days" – a count of the days individual hospital beds were occupied by patients – to measure the percentage of days hospital beds were occupied by patients identified as requiring an alternate level of care (ALC). meaning they did not require the type of care for which the bed was designated. Patients designated ALC are usually waiting for a place elsewhere in the health system that provides the type of care they need, such as a long-term care home or home care.