Homebound seniors lack access to adequate primary medical care although they are likely to be a frail population with multiple chronic health problems. While changes to Medicare hospital reimbursement policy and advances in medical technology have shifted health services into the home, physician services in the United States are still offered mainly at the clinic and the private office. Although anecdotal evidence of the clinical and cost-effectiveness of physician house calls exists, research on this topic is sorely lacking. This presentation describes the structure, process and intended/perceived outcomes of a physician house call programs based in a community hospital/health system. We used a case study method to describe the program, using qualitative data (focus groups and semi-structured interviews with the program staff and providers that were key to the program's operation as well as patients and their family) and quantitative data (data abstracted from medical and administrative records). The patients were the homebound who found it extremely difficult to get to their physicians' offices. The majority of them were elderly with multiple chronic problems referred by home care agencies, physicians and other health and social organizations. Enhancing access to primary care in the home, the program made a positive impact on patients (better medication and health management, optimal health), caregivers (empowerment and knowledge), and other health and social service providers (improved organizational function). Additional program outcomes including cost-effectiveness and policy implications will be discussed.
Learning Objectives: 1)Describe a physician housecall program in terms of the structure, process and intended/perceived outcomes. 2) Recognize the gap in the current helath care system for the homebound. 3) Identify opportunities and challenges in developing a physician housecall program.
Keywords: Home Care, Physicians
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: HomeCare Physicians at Central DuPage Health
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: grant