title: Management of alternate level of care patients using a computerized database.
abstract: The term "alternate level of care" (ALC) refers to the status of hospitalized patients who are no longer acutely ill but cannot be discharged because posthospital plans are not yet in place. ALC is a major problem for patients, families, and hospitals. This article describes the experiences of an urban teaching hospital with ALC and the development of a computerized database to better manage the ALC population. Among the findings were that age, waiting for a nursing home placement, family-related discharge problems, and pending Medicaid eligibility all significantly contributed to length of stay beyond the acute phase of the illness. Using these data, the hospital developed an innovative program in which the preparation of Medicaid applications was transferred from the Department of Finance to the Department of Social Work Services.
authors.affiliation: Department of Social Work Services, Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Rock
authors.forename: A
authors.initials: A
authors.lastname: Beckerman
authors.forename: C
authors.initials: C
authors.lastname: Auerbach
authors.forename: C
authors.initials: C
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Goldstein
authors.forename: E
authors.initials: E
authors.lastname: Quitkin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003660:Decision Support Systems, Management; D004608:Eligibility Determination; D005190:Family; D006301:Health Services Needs and Demand; D006801:Humans; D007902:Length of Stay; D008484:Medicaid; D009518:New York; D010351:Patient Discharge; D015397:Program Evaluation; D012307:Risk Factors; D012948:Social Work Department, Hospital / Q000458:organization & administration*; D013997:Time Factors; D014481:United States