Advertisement

The Past, Present, and Future of House Calls

      This article describes: the origin and evolution of house calls; what is uniquely gained from house calls for both patients and providers; key clinical issues managed at home; evidence that house calls improve outcomes; organization of house call practices; and changes in Medicare reimbursement, technology, and interdisciplinary team care that have influenced the delivery of home-based medical care.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Clinics in Geriatric Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Starr P.
        The social transformation of American medicine.
        Basic Books, New York1982 (p. 359)
        • Driscoll C.E.
        Is there a doctor in the house?.
        Am Acad Home Care Physicians News. 1991; 3: 7-8
        • Cherry D.K.
        • Burt C.W.
        • Woodwell D.A.
        National ambulatory medical care survey: 2001 summary.
        Adv data. 2003; 11: 337
        • Meyer G.S.
        • Gibbons R.V.
        House calls to the elderly—a vanishing practice among physicians.
        N Engl J Med. 1997; 337: 1815-1820
        • Aylin P.
        • Majeed F.A.
        • Cook D.G.
        • et al.
        Home visiting by general practitioners in England and Wales.
        BMJ. 1996; 313: 207-210
        • Keenan J.M.
        • Hepburn K.W.
        The role of physicians in home health care.
        Clin Geriatr Med. 1991; 7: 665-675
        • Elkan R.
        • Kendrick D.
        • Dewey M.
        • et al.
        Effectiveness of home based support for older people: systematic review and meta-analysis.
        BMJ. 2001; 323: 1-9
        • Leff B.
        • Burton J.R.
        Acute medical care in the home.
        J Am Geriatr Soc. 1996; 44: 603-605
        • Berenson A.
        • Abelson R.
        Weighing the costs of a CT scan's look inside the heart.
        New York Times. June 29, 2008;
        • McArthur W.J.
        Geriatric house calls: relic of the past or challenge of the future?.
        Can Fam Physician. 1990; 36 (1415): 1409-1411
        • Boling P.A.
        • Retchin S.M.
        • Ellis J.
        • et al.
        Factors associated with the frequency of house calls by primary care physicians.
        J Gen Intern Med. 1991; 6: 335-340
        • Taler G.
        House calls for the 21st century.
        J Am Geriatr Soc. 1998; 46: 246-248
        • Haupt B.
        • Hing E.
        • Strahan G.
        The national home and hospice care survey: 1992.
        Vital Health Stat 1. 1994; 117 ([summary]): 1-110
      1. Office of Inspector General, DHHS 1997. Operation restore trust: audit of Medicare home health services in California, Illinois, A-04-96-02121. Office of the Inspector General Press Office.

        • Muramatsu N.
        • Cornwell T.
        Needs of physician house calls—views from health and social service providers.
        Home Health Care Serv Q. 2003; 22: 17-29
        • Moore G.
        • Showstack J.
        Primary care medicine in crisis: toward reconstruction and renewal.
        Ann Intern Med. 2003; 138: 244-247
        • Colwill J.M.
        • Cultice J.M.
        • Kruse R.L.
        Will generalist physician supply meet demands of an increasing and aging population?.
        Health Aff. 2008; 27: w232-w241
        • ADGAP
        Status of Geriatrics Workforce Study.
        (Available at:) (Accessed July 20, 2008)
        • Steel R.K.
        • Musliner M.
        • Boling P.A.
        Medical schools and home care.
        NEJM. 1994; 331: 1098-1099
        • Committee on the Future Health Care Workforce for Older Americans
        • Institute of Medicine
        Retooling for an aging America: building the health care workforce.
        The National Academies Press, Washington (DC)2008
      2. Administration on Aging, US Department of Health and Human Services. A profile of older Americans: Washington (DC); Administration of Aging, US Department of Health and Human Services. 2007.

        • Boling P.A.
        The physician's role in home health care.
        Caring. 1998; 17: 10-15
        • Leff B.
        • Burton J.R.
        The future history of home care and physician house calls in the United States.
        J Gerontol. 2001; 56A: M603-M608
      3. Direct data source: Medicare Part B Summary Data 2005–2007; file prepared for American Academy of Home Care Physicians, August 2008.

        • Landers S.H.
        • Gunn P.W.
        • Flocke S.A.
        • et al.
        Trends in house calls to Medicare beneficiaries.
        JAMA. 2005; 294: 2435-2436
        • Smith K.L.
        • Ornstein K.
        • Soriano T.
        • et al.
        A multidisciplinary program for delivering primary care to the underserved urban homebound: looking back, moving forward.
        J Am Geriatr Soc. 2006; 54: 1283-1289
      4. (Available at:) (Accessed September 22, 2008)
      5. (Available at:) (Accessed October 2, 2008)
        • AGS
        Role of house calls in geriatric practice—clinical practice statement.
        (Available at:) (Accessed April 18, 2008)
        • Reuben D.B.
        • Fried T.R.
        • Wachtel T.J.
        • et al.
        When the patient cannot come to the doctor: a medical house calls program.
        J Am Geriatr Soc. 1998; 46: 226-231
        • Counsell S.R.
        • Callahan C.M.
        • Clark D.O.
        • et al.
        Geriatric care management for low-income seniors: a randomized controlled trial.
        JAMA. 2007; 298: 2623-2633
        • Yuen J.K.
        • Breckman R.
        • Adelman R.D.
        • et al.
        Reflections of medical students on visiting chronically ill older patients in the home.
        J Am Geriatr Soc. 2006; 54: 1778-1783
        • Stuck A.E.
        • Minder C.E.
        • Peter-Wuest I.
        • et al.
        A randomized trial of in-home visits for disability prevention in community-dwelling older people at low and high risk for nursing home admission.
        Arch Intern Med. 2000; 160: 977-986
        • Ramsdell J.W.
        • Swart J.O.
        • Jackson J.E.
        • et al.
        The yield of a home visit in the assessment of geriatric patients.
        J Am Geriatr Soc. 1989; 37: 17-24
        • Ramsdell J.W.
        • Jackson J.E.
        • Guy J.H.
        • et al.
        Comparison of clinic-based home assessment to a home visit in demented elderly patients.
        Alzheimer Dis Assoc Disord. 2004; 18: 145-153
        • Brumley R.D.
        • Enguidanos S.
        • Cherin D.A.
        Effectiveness of a home-based palliative care program for end-of-life.
        J Palliat Med. 2003; 6: 715-724
        • Ciemins E.L.
        • Stuart B.
        • Gerber R.
        • et al.
        An evaluation of the advanced illness management (AIM) program: increasing hospice utilization in the San Francisco Bay area.
        J Palliat Med. 2006; 9: 1404-1411
        • Stuck A.E.
        • Aranow H.U.
        • Steiner A.
        • et al.
        A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community.
        NEJM. 1995; 333: 1184-1189
        • Yudin J.
        • Kinosian B.
        • Graub P.B.
        • et al.
        [ElderPAC].
        (Available at:) (Accessed June 23, 2008)
        • Stuck A.E.
        • Egger M.
        • Hammer A.
        • et al.
        Home visits to prevent nursing home admission and functional decline in elderly people.
        JAMA. 2002; 287: 1022-1028
        • Gurley R.J.
        • Lum N.
        • Sande M.
        • et al.
        Persons found in their home helpless or dead.
        NEJM. 1996; 334: 1710-1716
        • Phillips S.
        Home based chronic care.
        (Available at:) (Accessed June 23, 2008)
        • Naylor M.D.
        • Brooten D.
        • Campbell R.
        • et al.
        Comprehensive discharge planning and home follow-up of hospitalized elders.
        JAMA. 1999; 281: 613-620
        • Desai N.R.
        • Smith K.L.
        • Boal J.
        The positive financial contribution of home-based primary care programs: the case of the Mount Sinai visiting doctors.
        J Am Geriatr Soc. 2008; 56: 744-749
        • Smigelski C.
        • Hungate B.
        • Holdren J.
        • et al.
        Transitional model of care at VCU medical center—6 years' experience.
        AGS Annual Meeting Abstract. April 2008;
        • Smith K.L.
        • Soriano T.A.
        • Boal J.
        Brief communication: national quality-of-care standards in home-based primary care.
        Ann Intern Med. 2007; 146: 188-192