As a third year student in York University’s PhD program in Health Policy and Equity, it is my belief that having a strong understanding of the complex interactions between various determinants of health as they apply to interventions and health care service utilization is necessary. Moreover, the recent trend in the reduction of funding and infrastructure support for health services is increasingly accentuating the context of the shortages of physicians and specialists which can hinder the sustainability of health services infrastructure, as well as, the availability of external support. Therefore, issues regarding equitable access to health care should involve innovative, evidence-based strategies and interventions that will improve the health policy making process. My research interests relates to theories and concepts of health sciences, human development, life course and finally gerontology with application to strategies that facilitate pro-health behavior change. I explore the health and social aspects of transitional care, levels of service intensity and interventions necessary from a hospital facility to an outpatient setting. My studies include but are not be limited to comparisons with urban and global scenarios and provide a platform to build on the opportunities of the health care spectrum using both qualitative and quantitative methods.
More Harm Than Good? The Alternate Level of Care Co-payment Policy
Alternate-level-of-care (ALC) patients in Ontario hospitals present potential implications to hospital operational efficiency. Considering that the co-payment policy was adapted as a disincentive to prevent patients from unnecessarily utilizing acute care services and resources, this study provided a commentary on the unintended effects of this policy on ALC.
A keyword search yielded 302 PubMed and 729,000 Google Scholar articles published between 2010-2016, which were sorted, and quality assessed resulting in eight articles. A synthesis of results from the selected articles illustrated consequences and offers strategies for further research, potential pragmatic recommendations, as well as a context for knowledge translation, mobilization, and dissemination, which will not only benefit stakeholders but also provide a platform in which to reorient future policy improvement and research. As most of the selected articles were retrospective studies, it offered hindsight information as to who makes up the ALC population, and what underlying issues are not addressed by current policies and strategies.
The co-payment policy is counterproductive due to non-compliance, capacity constraints, and operational deficiencies within the system. The co-payment policy may ease the acute care strain, by expediting discharge, it fails to acknowledge the existing capacity constraints, ALC characteristics and fragments along the continuum of care. If these preceding factors are not addressed, a host of other problems will surface and continue to persist. with, high occupancy rates, readmission, and costly healthcare and hospital expenditures.
Actions taken to respond to the consequences of delayed discharges should focus on supporting the achievement of good patient experiences, decreased hospital occupancy, and increased operational efficiency.
Keywords: alternate level of care, co-payment policy, long-term care, hospital occupancy, delayed discharge