Hospital outreach service: helping to prevent nursing home placement.

An outreach service from a post-acute metropolitan teaching hospital delivered an intensive, multidisciplinary and coordinated allied health service, and achieved both early hospital discharge and the prevention or delay of nursing home placement. This article reports on three types of cases which illustrate how the service assisted ward teams, families and patients to determine whether nursing home placement was essential. For a group of 20 cases, the total reduction in hospital length of stay was 556 days, and home accommodation as an alternative to nursing home accommodation was achieved for a total of 7505 days. The article outlines a matrix of advantages and disadvantages, both tangible and intangible, of home versus nursing home accommodation. It is suggested that a full costing of this matrix would inform debate on the comparative merits of long-term home and nursing home accommodation.