Concept: Alternate Level of Care (ALC) Patients - Method of Identification

Concept Description

Last Updated: 2014-04-21



1. Coded ALC Patients

ALC Reason Codes

    In Manitoba there are five major categories of ALC Reason Codes for why a patient is designated as ALC and each patient can be assigned up to three ALC Reason Codes in one hospitalization. The group code values and description for each of the major categories are:

    • 10 - Panel Process for possible placement in PCH or Chronic Care facility;
    • 20 - Waiting for Home Care or Community Care Services;
    • 30 - Waiting for other placement such as a group home, supportive housing or hospice;
    • 40 - Waiting due to other reasons such as respite, as a boarder baby or boarder mother or awaiting support or accommodation; and
    • 50 - Rehabilitation Services (WHRA only).

    Each major category has specific detailed codes that should be recorded in the abstract. Major group code values should not be recorded in the abstract. For a complete listing of all ALC Reason Codes see the ALC Reason Code definition in Fransoo et al. (2013).

    On/Off Dates and ALC Length of Stay (ALCLOS)

    For each ALC Reason Code there should be a corresponding set of "on and off" (start and stop) dates. These are recorded in the variables: alc_ondt1 to alc_ondt3 and alc_offdt1 - alc_offdt3. These variables can be used to calculate the ALC length of stay (ALCLOS). Beginning with 2007/2008 hospital data, a variable ALCLOS is also available. ALCLOS is the total number of hospital days designated as ALC for that hospital stay.

ALC-Related Z Codes

    The Z codes are part of the International Classification of Diseases (ICD-10-CA) diagnoses codes that fall under the category "Factors influencing health status and contact with health services." These codes do not assign a diagnosis due to illness or injury, but rather provide supplementary information as to the patient's status and/or reason for admittance to or remaining in the hospital. Examples include routine physical examinations, vaccinations or outcome of delivery.

    There are certain Z codes that are related to Alternate Level of Care (ALC), but they are not limited to ALC designation and may be used for any patient. Every patient designated ALC should have an ALC-related Z code in their hospital abstract to indicate the reason the patient was designated ALC. Coded ALC patients may have one or more ALC-related Z code recorded to indicate the reason for ALC designation (Canadian Institute of Health Information, 2010).

    For a listing of ALC-related Z codes used in Fransoo et al. (2013), see the Z Code definition.

2. Possible ALC Hospitalizations

ALC Algorithm Hierarchy

Results and Findings

Limitations / Cautions

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