Updating the House Call: Elderly and Disabled Most in Need, Funding Unclear

Review of the current status of home medical care

Researchers at George Washington University School of Medicine and Health Sciences studied the current status of home medical care, conducted an assessment of the need for home medical care, and identified models of and barriers to providing this care.

Home medical care provides medical assessment, diagnosis, and treatment services and is performed by medical professionals such as physicians and nurse practitioners.

As part of the study, the principal investigators conducted interviews with experts in the home medical care field, focus groups with nurses and physicians, and a review of the medical literature to assess the current need for home medical care.

Key Findings

Findings of the study included:

  • Most home medical care models use interdisciplinary teams of physicians, nurse practitioners, and social workers.
  • Limited payment, lack of training, and physician "territorialism" are key barriers to the expansion of home medical care.
  • It is unclear whether recent changes in federal funding will affect the willingness of medical practices to expand into home medical care.

Recommendations

The research team identified 15 models of home medical care currently in use, and they developed their own model program, which they estimated would cost $3,000 per patient per year.

The researchers recommended that the Robert Wood Johnson Foundation (RWJF) and others:

  • Support the development of home medical care.
  • Examine the most cost-effective mix of providers.
  • Consider the possible impact of technology.
  • Study financing issues.

Funding

RWJF supported the project with a $35,383 grant from August 1998 to to January 2000.

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