Home visits by care providers – Influences on health outcomes for caregivers of homebound older adults with dementia

Fowler, Christianne; Kim, Miyong T.

doi:10.1016/j.gerinurse.2014.09.002

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…. (2016)EXCLUDE on study designEklund et al (2013)EXCLUDE on settingElbadawy (2017)EXCLUDE on settingEl‐Khoury et al (2015)EXCLUDE on settingEloranta (2010)EXCLUDE on study designEngberg et al (1997)EXCLUDE on study designEvans (2007)EXCLUDE on study designFahlman et al (2007)EXCLUDE on settingFairhall et al (2015)EXCLUDE on study designFanning et al (2018)EXCLUDE on settingFarmer et al (2006)EXCLUDE on study designFeldman et al (2005)EXCLUDE on interventionFernandez‐Barres et al (2017)EXCLUDE on interventionFields et al (2014)EXCLUDE on settingFinkelstein and Fuller (2012)EXCLUDE on study designFischer et al (2015)EXCLUDE on study designFitzgerald et al (1994)EXCLUDE on settingFleet et al (2014)EXCLUDE on interventionFlora and Faulkner (2006)EXCLUDE on study designForbes (2002)EXCLUDE on study designForster et al (2008)EXCLUDE on settingForster et al (2017)EXCLUDE on interventionFowler and Kim (2015)EXCLUDE on study designGalle et al (2017)EXCLUDE on settingGary (2006)EXCLUDE on interventionGhassemzadeh et al (2013)EXCLUDE on study designGianoudis et al (2011)EXCLUDE on settingGibson (2002)EXCLUDE on study designGie...…”

Section: References To Studiesmentioning

confidence: 99%

Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map

Welch

Mathew

Babelmorad

et al. 2021

Campbell Systematic Reviews

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Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and http://ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on‐going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de‐duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality. The most common interventions were home‐based rehabilitation for older adults (n = 276) and home‐based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental functio...

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Section: References To Studiesmentioning

confidence: 99%

Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map

Welch

Mathew

Babelmorad

et al. 2021

Campbell Systematic Reviews

View full text Add to dashboard Cite

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“…Whereas previous studies of home visit physicians focused on specific patient populations (e.g., palliative, homebound, frail or older patients 2,4,6,7,[17][18][19] ), we examined all family physicians who provided home visits. However, our finding that high-volume physicians saw more patients receiving palliative care than low-volume physicians suggests this is a growing area of care.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these practise within a medical home, known in Ontario as a primary care enrolment model, 16 where they work in a group of physicians who share accountability for afterhours care, formally enroll patients and receive some blended payments. 2,4,6,7,[17][18][19] Physicians not working in a medical home are paid on a fee-for-service basis. 16 About 93% of Ontarians aged 16 years or older have a primary care provider, and 82% are formally enrolled in a medical home.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and practice patterns of family physicians who provide home visits in Ontario, Canada: a cross-sectional study

Salahub

Kiran

et al. 2023

cmajo

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Background: Physician home visits are essential for populations who cannot easily access office-based primary care. The objective of this study was to describe the characteristics, practice patterns and physician-level patient characteristics of Ontario physicians who provide home visits. Methods: This was a retrospective cross-sectional study, based on health administrative data, of Ontario physicians who provided home visits and their patients, between Jan. 1, 2019, and Dec. 31, 2019. We selected family physicians who had at least 1 home visit in 2019. Physician demographic characteristics, practice patterns and aggregated patient characteristics were compared between high-volume home visit physicians (the top 5%) and low-volume home visit physicians (bottom 95%). Results: A total of 6572 family physicians had at least 1 home visit in 2019. The top 5% of home visit physicians ( n = 330) performed 58.6% of all home visits ( n = 227 321 out of 387 139). Compared with low-volume home visit physicians ( n = 6242), the top 5% were more likely to be male and practise in large urban areas, and rarely saw patients who were enrolled to them (median 4% v. 87.5%, standardized mean difference 1.12). High-volume physicians’ home visit patients were younger, had greater levels of health care resource utilization, resided in lower-income and large urban neighbourhoods, and were less likely to have a medical home. Interpretation: A small subset of home visit physicians provided a large proportion of home visits in Ontario. These home visits may be addressing a gap in access to primary care for certain patients, but could be contributing to lower continuity of care.

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“…14,20 Patient-centered care services like HBMC may improve quality of life and health for the affected individual and their caregiver, as well as contribute to stewardship of healthcare utilization. 9,10,12 Most "home care" is episodic rehabilitative or skilled nursing care, with little or no physician involvement. In a recent study of generalist physicians commonly engaged with skilled home health recipients, 78% reported rarely or never interacting with skilled home health clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Receipt of HBMC is associated with reductions in disability, depression, and healthcare utilization; [9][10][11] it also can benefit caregiver health. 12 The most recent national survey of HBMC providers reported high rates of interdisciplinary team care despite the fact that a preponderance of HBMC practices do not directly employ non-billing providers (e.g. social workers).…”

Section: Introductionmentioning

confidence: 99%

What’s Happening at Home

et al. 2019

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Background: Home clinical care (HCC) includes home-based medical care (HBMC-medical visits in the home) and skilled home health care (skilled nursing or therapy visits). Over seven million older adults would benefit from HCC; however, we know surprisingly little about homebound older adults and HCC. Objective: To describe HCC received by older adults using claims data within the OptumLabs® Data Warehouse.

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Home visits by care providers – Influences on health outcomes for caregivers of homebound older adults with dementia

Cited by 6 publications

References 31 publications

Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map

Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map

Characteristics and practice patterns of family physicians who provide home visits in Ontario, Canada: a cross-sectional study

What’s Happening at Home

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