Home Care: Much Needed, Much Neglected

Somers, Anne R.; Bryant, Nancy H.

doi:10.7326/0003-4819-82-1-111

Cited by 7 publications

(2 citation statements)

References 1 publication

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“…Home care has become a viable and revived concept of medical care. The subject has recently been reviewed and discussed elsewhere (2)(3)(4)(5)(6), including differences of opinions concerning its merits (7)(8)(9)(10). Home care has recently received attention from government and other third-party payers (11)(12)(13)(14) and from many medical institutions and individuals (personal communications).…”

Section: Discussionmentioning

confidence: 99%

Physician House Calls: A Complement to Hospital‐Based Medical Care

Mims

Thomas

Conroy

1977

J American Geriatrics Society

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A physician-oriented, hospital-based Home Care Program (HCP) is described. The staff includes a director, resident physicians, nurses, social workers, and clerical personnel. House calls are made by resident physicians during off-duty hours, but patients, their families, and other health professionals may help with their care. Drugs, equipment and supplies are available through the hospital and contract vendors. The most common medical diseases are cardiac and cerebrovascular disorders, arthritis, diabetes mellitus, chronic pulmonary disorders and hypertension. Of 513 patients evaluated in one year, 337 were admitted to the HCP. Two-thirds were women. Ages ranged from 18 to 106 (median, 68 years). Under the HCP there was significant improvement and control of the medical problems, and a decrease in hospital and emergency room admissions, and clinic visits; 207 of the 337 patients were discharged. The HCP cost less than other outpatient and inpatient services. It proved to be a rewarding, economical and effective means of improving medical care for a metropolitan population dependent upon hospital-based physicians for medical services.

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Section: Discussionmentioning

confidence: 99%

Physician House Calls: A Complement to Hospital‐Based Medical Care

Mims

Thomas

Conroy

1977

J American Geriatrics Society

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“…This was accomplished with an annual budget of $35,000 in no small part due to the fact that the professional staff volunteered their time 3 . In an editorial accompanying this article, Somers and Bryant were prophetic when they wrote in reference to home care, “despite all the lip‐service, however, we are unlikely to witness any rapid overall expansion.” 4 They noted that home health services were actually declining under Part A of Medicare between 1969 and 1973, The reasons were judged to be that most physicians were not interested in either chronic illness or home care and that most hospital administrators were “primarily concerned with keeping their expensive beds filled.” There was clearly no incentive under a cost‐reimbursement payment system for a hospital to provide home care services. Furthermore the major third party payors influenced by the public's decision to preferentially provide bricks and mortar to the health care industry, as well as by the heady ambrosia associated with a sexy technology, paid little attention to services outside of the hospital.…”

Section: Home Medical Service 1984–1985: Partial Listing Of Communmentioning

confidence: 99%

Physician‐Directed Long‐Term Home Health Care for the Elderly—A Century‐Long Experience

Steel

1987

J American Geriatrics Society

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Needs assessment for hospital‐based home care services

Inui

Stevenson

Plorde

et al. 1980

Research in Nursing & Health

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Careful needs assessment is a prerequisite to addressing issues of health care program effectiveness and program planning from a population-based perspective. Home care program evaluation literature is lacking in examples of strategies for such assessment. A nurse-screening of admissions was conducted at an acute care general hospital to estimate need for hospital-based home care (HBHC) services among the 2,613 patients discharged from medical and surgical services over a 5-month period. After careful delineation of inclusion and exclusion criteria for identifying HBHC patients and participant-observer training, the nurse's judgments on patient appropriateness for HBHC care were shown to agree reliably with those of the HBHC staff (k = + .45). In the study hospital under current conditions, an estimated 64% of discharged patients appropriate for home care do not receive these services. A comparison of the incidence according to service of HBHC-appropriate patients and patient-referral rates to HBHC suggests that one service over-refers (neurology), but most under-refer. Screening nurse salary expenditures constitute the major costs of this approach to home care needs assessment, which is recommended only for addressing major, infrequent programmatic policy issues.

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Home Care: Much Needed, Much Neglected

Cited by 7 publications

References 1 publication

Physician House Calls: A Complement to Hospital‐Based Medical Care

Physician House Calls: A Complement to Hospital‐Based Medical Care

Physician‐Directed Long‐Term Home Health Care for the Elderly—A Century‐Long Experience

Needs assessment for hospital‐based home care services

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