Term: Alternate Level of Care (ALC)
Last Updated: 2013-10-04
In Fransoo et al. (2013), alternate level of care (ALC) is defined as follows ... a patient may be designated as ALC if he or she is occupying an acute care hospital bed but is no longer acutely ill and does not require the intensity of resources and services provided in an acute care setting. The patient must be designated as ALC by a physician or his or her authorized designate. All ALC patients should have the following coded on their hospital abstract: (i) at least one ALC Reason Code, (ii) an ALC-related Z code, and (iii) either a main Patient Service Code or Service Transfer Code of 99, "Alternate Level of Care" (Canadian Institute for Health Information (CIHI), 2010).
In De Coster et al. (1996), alternate level of care (ALC) is defined as alternative care that would have been more appropriate for a patient who did not meet the criteria for acute/acuteness, had it been available. Thirteen possible alternatives were identified, including: residence, outpatient services, home care, minimal supervision, hospice, rehabilitation, Personal Care Home (PCH), chronic care, observation, respite care, room-in, crisis / protection, and organic brain illness. (De Coster et al., 1996) See a list of ALC categories and definitions in the Appendix from De Coster et al., 1996.