The Home Care Practice and Attitudes of Minnesota Family Physicians

Keenan, Joseph M.; Bland, Carole J.; Webster, Linda A.; Myers, Shepherd

doi:10.1111/j.1532-5415.1991.tb02876.x

Cited by 17 publications

(21 citation statements)

References 8 publications

(8 reference statements)

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“…Nevertheless, surveys indicate that over 90 percent of house calls by physicians are made to elderly patients and thus would have been captured by our sampling method. 6 Reliance on only a calendar year's worth of data could have resulted in underestimation of the association of house calls with end-of-life care for beneficiaries. Our comparisons among physicians are limited because the physicians who did not make house calls to our 5 percent sample of beneficiaries may have made house calls to patients in the other 95 percent of the Medicare population.…”

Section: Discussionmentioning

confidence: 99%

“…5 Along with the decline in their number, the nature of house calls changed; they went from being a common mode of health care delivery for all patients to a type of care reserved primarily for the elderly. 6 In 1988, Medicare -the principal agency paying for physicians' house calls -was billed for only 1.6 million house calls. 7 Despite their decline, surveys document the continued perception among generalist physicians that house calls are a valuable component of patient care, provide personal gratification, and improve patients' satisfaction.…”

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confidence: 99%

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House Calls to the Elderly — A Vanishing Practice among Physicians

Meyer

Gibbons

1997

N Engl J Med

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

House Calls to the Elderly — A Vanishing Practice among Physicians

Meyer

Gibbons

1997

N Engl J Med

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“…Bergeron et al (20) reported that an increase by 50% could occur in the number of current home visits by providing appropriate economic balances. Keenan et al (14,21) conducted two separate studies and reported strong dissatisfaction among physicians about repayments made for home visits. Hayton et al (12) also reported that limited time and financial inadequacy were the limiting factors for home visits.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Effects of Education Provided to the Family Physicians on Home Visits in Primary Care Setting in Burdur Province in 2011 on Physicians’ Knowledge, Skills and Attitudes

Öner¹,

Kavukçu²,

Akdeniz³

et al. 2014

Erciyes Med J

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Objective: Home visit is an essential part of primary health care services. In Turkey, as is all over the world, need for home visits will increase with aging population. The number of studies carried out by physicians on home visits in Turkey is quite limited. In the present study, we aimed to make a favorable change in family physicians' knowledge and attitudes about home visits via an education on home visits. Materials and Methods:The present study was conducted as a dissertation project. The universe of this study, which is a cross-sectional study, comprised all family physicians, who were working at Family Health Centers (FHCCs) affiliated to Burdur Provincial Directorate of Health and volunteer to participate in the study. A total of 72 family physicians, 37 being in the intervention group and 35 being in the control group, participated in the study. At the beginning of the study, a survey on home visits was performed in both groups; whilst the intervention group received education on home visits, the control group did not. The survey was repeated after three months and the intervention group underwent a core exam. Data obtained were transferred to the Statistical Package for the Social Sciences (SPSS) 18.0 statistics program and were analyzed. Intervention and control groups were compared. Additionally, pre-and post-education results of the intervention group were also compared.Results: Of 72 physicians received the first survey, 39 (54.2%) reported that family physicians should perform home visits and 18 (25%) physicians reported that they should not, whereas 15 (20%) were undecided. Thirty-one (43.1%) of 72 physicians were in the opinion that they performed adequate number of home visits. There were 26 (36.1%) family physicians thinking that the number of home visits they performed was not adequate, whereas 15 (20.8%) family physicians were undecided. Although the number of physicians, who considered the number of home visits they performed adequate, increased after education, it was not statistically significant. Whilst 44.4% (n=32) of the family physicians were eager about home visits, 45.8% (n=33) were not. The rate of eagerness increased after the education.Conclusion: Knowledge and skills of the family physicians were enhanced with the education on home visits as was expected. While the rate of eagerness about home visits was increased, expected increase in the rate of home visits was not achieved.

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“…However, the site of physician care remains the office or the clinic, despite the barriers faced by homebound older patients in reaching their physician's office, such as lack of reimbursement for ambulance rides used for non‐emergent care 3 . The annual number of physician home visits has undergone a steady decline 4 . With the notable exception of physicians who provide visits as part of a few medical school‐affiliated homecare programs 5 and the Veterans Administration Hospital‐based Home Care program, 6 the housecall is considered to be legally risky, inconvenient, inefficient, and insufficiently reimbursed 3,4,7,8 .…”

mentioning

confidence: 99%

MODELS OF GERIATRICS PRACTICE: When the Patient Cannot Come to the Doctor: A Medical Housecalls Program

Reuben

Fried

Wachtel

et al. 1998

J American Geriatrics Society

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OBJECTIVES: To describe a medical housecalls program and to assess its ability to meet the medical needs of homebound patients. PROGRAM STRUCTURE: The housecalls program is part of a larger ambulatory practice situated in a senior center staffed by geriatricians and nurse practitioners. The practice serves as the major teaching site of outpatient geriatrics for a medical residency program. Scheduled visits are made every 3 to 4 months, and unscheduled visits are made weekday days for acute problems. PARTICIPANTS: Patients are eligible for the housecalls program if they live within a 15‐ minute drive of the center and are unable to leave their home. PROGRAM EVALUATION: The majority of the 71 patients in the housecalls program between 1993 and 1995 were female (81%), aged 85 years or older (52%), and dependent in one or more activities of daily living: 65% were dependent in bathing and 42% in dressing. A substantial minority (16%) had severe cognitive impairment. Patients received a mean of 5.0 visits per patient‐year. The majority of patients (59%) were treated at home for an acute illness or symptom ranging from upper respiratory tract infections to pneumonia and congestive heart failure. Approximately one‐quarter of the patients or their proxies elected to avoid hospitalization; several of these patients had complex illnesses managed in their homes. CONCLUSIONS: A wide range of medical problems can be addressed in patients' homes. Because our patients could not leave their homes easily, or at all, it is probable they would not have received routine medical care and would have used the emergency room for evaluation of acute problems if the housecalls program were not available. Despite their potential value in the care of frail older patients, housecalls will likely not become a widespread practice until barriers to their performance cited by physicians are addressed.

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The Home Care Practice and Attitudes of Minnesota Family Physicians

Abstract: The survey documented continued decline (from previously published surveys) of physician home visiting behavior and widespread dissatisfaction with reimbursement. However, attitudes regarding home care provided by other professionals were highly positive.

Cited by 17 publications

References 8 publications

House Calls to the Elderly — A Vanishing Practice among Physicians

House Calls to the Elderly — A Vanishing Practice among Physicians

Assessment of Effects of Education Provided to the Family Physicians on Home Visits in Primary Care Setting in Burdur Province in 2011 on Physicians’ Knowledge, Skills and Attitudes

MODELS OF GERIATRICS PRACTICE: When the Patient Cannot Come to the Doctor: A Medical Housecalls Program

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