title: Dinner Bed and Breakfast for Older People: early experiences of a short-term service to manage acute hospital demand.
abstract: OBJECTIVE
  The paper describes a service (Dinner Bed and Breakfast [DBB]) to provide short-term rest home care to acutely unwell elderly people as an alternative to acute hospital admission. This was part of a larger project to manage acute general hospital demand. Service changes were introduced after an initial audit cycle and key outcomes monitored.
  
  
  METHODS
  Retrospective audit of patient data for three audit periods.
  
  
  RESULTS
  The interim outcomes (at conclusion of DBB funding) in the initial audit were 46% of patients able to return home, 32% remained in the rest home, and 22% were admitted to hospital. The proportion of patients returning home from DBB increased to 68% over the study period. At final outcome (at end of index illness), the return home rate increased from 73% to 85% and the number requiring permanent rest home care decreased from 22% to 14%.
  
  
  CONCLUSIONS
  Short-term rest home care may be a viable alternative to acute hospital care, but the service needs to include appropriate patient selection, multidisciplinary care, and ongoing monitoring of patient outcomes. One of the risks of this service is patients staying on in rest home care. Short-term enhanced home care may be preferable to rest home care to avoid this risk. The shift of care (from acute hospital to community) caused strain on specialist geriatric services, which was not planned or funded.
authors.affiliation: Older Persons Health, The Princess Margaret Hospital, Christchurch, New Zealand. carl.hanger@cdhb.govt.nz
authors.forename: Carl
authors.initials: C
authors.lastname: Hanger
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Griffith
authors.forename: Sarah
authors.initials: S
authors.lastname: Lynn
authors.forename: Graham
authors.initials: G
authors.lastname: McGeoch
authors.forename: Paul
authors.initials: P
authors.lastname: Abernethy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006302:Health Services Research; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008485:Medical Audit; D009735:Nursing Homes; D012046:Rehabilitation / Q000706:statistics & numerical data*; D012144:Respite Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies