Costa Andrew P, Hirdes John P
Research Associate, Department of Health Studies and Gerontology, University of Waterloo, Waterloo, ON.
Healthc Policy. 2010 Aug;6(1):32-46.
Alternate-level-of-care (ALC) patients waiting for admission to long-term care (LTC) in Ontario hospitals are an important subgroup of ALC patients. Understanding the characteristics of ALC patients waiting for LTC can identify opportunities for alternative discharge options.
Characteristics from a sample of 13,915 ALC patients waiting for LTC in acute and complex hospitals were analyzed and compared to those from a sample of 113,046 long-stay home care clients in Ontario. Population-level data were obtained using Ontario's RAI-HC database for the period January 2007 to September 2008.
Relative to older long-stay home care clients, ALC patients waiting for LTC admission have more functional impairment and complex health needs. A combination of targeted transitional care and more resource-intensive home care services are needed to successfully address ALC patients' care needs in the community.
A substantial portion of ALC patients waiting for LTC placement in acute and complex care hospitals may be more appropriately cared for in community settings if adequate community-centred resources are put in place.
安大略省医院中等待入住长期护理机构（LTC）的不同护理级别（ALC）患者是ALC患者中的一个重要亚组。了解等待入住LTC的ALC患者的特征可以确定替代出院选择的机会。
对急性和综合医院中13915名等待入住LTC的ALC患者样本的特征进行了分析，并与安大略省113046名长期居家护理客户样本的特征进行了比较。使用安大略省的RAI-HC数据库获取了2007年1月至2008年9月期间的人群水平数据。
相对于年长的长期居家护理客户，等待入住LTC的ALC患者有更多的功能障碍和复杂的健康需求。需要有针对性的过渡护理和资源更密集的居家护理服务相结合，才能在社区中成功满足ALC患者的护理需求。
如果有足够的以社区为中心的资源，那么在急性和综合医院中等待入住LTC的很大一部分ALC患者可能在社区环境中得到更适当的护理。
