Healthcare Quarterly

Healthcare Quarterly 24(4) January 2022 : 27-33.doi:10.12927/hcq.2022.26714
Examining Resource Allocations

Using Case Costing to Evaluate the Potential Impact of a Reintegration Unit on an Acute-Care Hospital’s Capacity and Resources

Ivy Cheng, Clare L. Atzema, Debra Carew, Stacy Landau, Debra Walko, Wendy Li, Yan Yan Ma and G Ross Baker


The Ontario Ministry of Health funded a reintegration unit to transition hospitalized patients who no longer required acute care to alternate level of care (ALC), such as long-term care. In its first year, 102 (3.5%) patients of the hospital's waiting-for-ALC population were transferred, with 37.3% transferred on the day of ALC readiness. The reintegration unit reduced direct hospital costs by $861,000. Using case costing, we modelled optimized scenarios including all transfers on the day of ALC readiness and increased transfers to the reintegration unit; this helped reduce avoided direct costs by $2.3–$5.4 million. Acute-care bed capacity could have increased by 11%. We outline strategies to optimize future performance of the reintegration unit.



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