Maisonnave Mariano, Rajabi Enayat, Taghavi Majid, VanBerkel Peter
Shannon School of Business, Cape Breton University, Sydney.
Sobey School of Business, Saint Mary's University, Halifax.
Can Geriatr J. 2024 Dec 1;27(4):519-530. doi: 10.5770/cgj.27.755. eCollection 2024 Dec.
There has been increasing concern over the growing number of Alternate Level of Care (ALC) patients in Canada who must wait in hospitals for more appropriate settings to meet their needs. ALC patients may have to stay in hospitals for days or months due to a lack of available long-term care capacity, home care services, or other discharge routes.
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) method to review 35 papers on the topic of ALC patients and delayed discharge in Canada from different perspectives, including (1) the shared characteristics of ALC patients in Canada; and (2) their impact on the Canadian health-care system, medical staff, and family members. Furthermore, from the reviewed works, (3) we also investigate the factors that impact the length of the hospital stays.
We highlighted how the ALC problem is increasing healthcare costs, disrupting services, increasing waiting times, and compromising access to valuable resources. We found evidence suggesting that this far-reaching crisis affects the patients, their families, and the medical personnel. We discovered several logistical issues (such as access to long-term care) affecting the patient's hospital length of stay.
Our research contributes to understanding this intricate problem, and helps policymakers take steps to tackle this challenge to ensure timely and appropriate care for all patients.
加拿大需要在医院等待更合适的安置以满足其需求的替代护理级别(ALC)患者数量不断增加,这引发了越来越多的关注。由于缺乏可用的长期护理能力、家庭护理服务或其他出院途径,ALC患者可能不得不在医院停留数天或数月。
我们使用系统评价和Meta分析扩展版的首选报告项目(PRISMA-ScR)方法,从不同角度对35篇关于加拿大ALC患者和延迟出院主题的论文进行综述,包括:(1)加拿大ALC患者的共同特征;(2)他们对加拿大医疗保健系统、医务人员和家庭成员的影响。此外,从已审查的文献中,(3)我们还调查了影响住院时间长短的因素。
我们强调了ALC问题如何增加医疗成本、扰乱服务、延长等待时间并影响获取宝贵资源。我们发现有证据表明,这场影响深远的危机影响着患者、他们的家人和医务人员。我们发现了几个影响患者住院时间长短的后勤问题(如获得长期护理的机会)。
我们的研究有助于理解这个复杂的问题,并帮助政策制定者采取措施应对这一挑战,以确保为所有患者提供及时和适当的护理。