In an optimal healthcare system, patients receive care in the most appropriate, least expensive setting. In Canada, too many patients remain in hospital well after they no longer require hospital-based care. This study examines the observations on this problem by a team with a home and community lens in six cases. The underlying issues across the six are the insufficiency of home and community supports before hospitalization, the routine underestimation of these patients' potential for independence, the deconditioning of patients while in hospital, and hospital staff's lack of understanding of home care. Addressing these issues would help many of these patients transition from hospital to less costly, more fitting settings.
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Bender et al. (2018) studied this question.
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