Bibliographic record
Abstract
Alternate level of care (ALC) is a designation used in Canada that is applied by clinical staff to that portion of a patient’s hospital stay when the patient is occupying a bed in a facility (e.g., acute care hospital) and does not require the intensity of resources or services typically provided in that care setting. (In other parts of the world ALC is often referred to as delayed discharge.) There are several reasons that patients who have been designated as ALC continue to occupy a hospital care bed or use hospital resources. People may present to a hospital emergency department for nonacute medical or social reasons because of a real, or perceived, lack of access to more appropriate services (e.g., primary care, community supports). Patients may require new or additional services and be waiting for availability, such as home care or specialized care. To address the challenges associated with ALC designations, we explored strategies and initiatives that are being considered or implemented to enhance the infrastructure and support systems aimed at reducing ALC rates in Canada. This work builds on a previous request from a health care decision-maker for a report describing how health care centres or regions in Canada are handling ALC and any strategies they have found that successfully decrease hospital wait times or length of stay and increase patient flow. This work also builds on previous health systems work undertaken by Canada’s Drug Agency, including emergency department overcrowding and aging in place.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".