Max Rady College of Medicine

Term: Alternate Level of Care (ALC)

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Glossary Definition

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.

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Related terms 


  • Canadian Institute for Health Information. Discharge Abstract Database Abstracting Manual, 2010-2011 Edition. Ottawa, ON: Canadian Institute for Health Information, 2010.(View)
  • De Coster C, Peterson S, Kasian P. Alternatives to Acute Care . Winnipeg, MB: Manitoba Centre for Health and Evaluation, 1996. [Report] [Summary] (View)
  • Fransoo R, Martens P, The Need to Know Team, Prior H, Burchill C, Koseva I, Rajotte L. Who is in our Hospitals.and why? Winnipeg, MB: Manitoba Centre for Health Policy, 2013. [Report] [Summary] [Additional Materials] (View)

Term used in 

  • Bruce S, Black C, Burchill C, De Haney S. Profile of Medical Patients who were Assessed as Requiring Observation-Level Services at Winnipeg Acute Care Hospitals in 1998/99. Winnipeg, MB: Manitoba Centre for Health Policy, 2002. [Report] [Summary] (View)
  • Menec VH, Bruce S, MacWilliam L. Exploring reasons for bed pressures in Winnipeg acute care hospitals. Can J Aging 2005;24 Suppl 1(Suppl 1):121-131. [Abstract] (View)

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