Physicians, health administrators, patients, and families all know that Canada’s hospitals are full of patients who don’t want to be there. What is surprising, though, is that many don’t need to be there.

Why are so many patients admitted to hospitals in the first place? As emergency physicians, one of our main tasks is to decide who requires hospitalization and who can safely return home. One of the most common rationales for admission is that a patient has “failed the road test”, like a senior unable to mobilize after a hip or knee sprain.

Such problems do not require acute care medicine, but a hospital bed is the only place where unscheduled personal support care can be provided immediately. Considering acute care beds cost our system up to $2,000 per day, this is tragically poor valu

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