Alternate Level of Care Patients in Canada: a Scoping Review.

Background: 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. Method: 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. Results: 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. Conclusions: 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.