Acute-care hospitalizations and long-term care: an examination of transfers.

A Long-term Care Program was introduced throughout British Columbia, Canada, on January 1, 1978. This comprehensive community-based program emphasizes home care. A longitudinal study was started of all persons (N = 3518) admitted to the program that year in two health districts, one urban and one semirural. An examination of the relationship between acute-care hospitalization and long-term care (LTC) involved determining (1) the number of admissions (N = 364) to LTC directly from acute-care settings versus the number (N = 1287) entering directly from the community, (2) the number of LTC persons who were hospitalized at least once in the first 12 months after admission to LTC, and (3) the outcomes of these hospitalizations. Persons from the urban area who entered the LTC Program from an acute-care hospital were much more likely to be institutionalized than were those from the semirural area. In the LTC facility group, 388 persons (19.9 per cent) experienced at least one acute-care hospitalization during the first year of the program. More than 50 per cent of those transferred to an acute-care hospital for the first time returned to the same location and level of care afterward; 14 per cent died. These descriptive analyses may be of interest to health-care planners and to those who care for the LTC elderly either at home or in a facility.