House calls for seniors

Building and sustaining a model of care for homebound seniors

Robin Beck, Alejandro Arizmendi, Christianna Purnell, Bridget A. Fultz, Christopher Callahan

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Homebound seniors suffer from high levels of functional impairment and are high-cost users of acute medical services. This article describes a 7-year experience in building and sustaining a physician home visit program. The House Calls for Seniors program was established in 1999. The team includes a geriatrician, geriatrics nurse practitioner, and social worker. The program hosts trainees from multiple disciplines. The team provides care to 245 patients annually. In 2006, the healthcare system (62%), provider billing (36%), and philanthropy (2%) financed the annual program budget of $355,390. Over 7 years, the team has enrolled 468 older adults; the mean age was 80, 78% were women, and 64% were African American. One-third lived alone, and 39% were receiving Medicaid. Reflecting the disability of this cohort, 98% had impairment in at least one instrumental activity of daily living (mean 5.2), 71% had impairment in at least one activity of daily living (mean 2.6), 53% had a Mini-Mental State Examination score of 23 or less, 43% were receiving services from a home care agency, and 69% had at least one new geriatric syndrome diagnosed by the program. In the year after intake into the program, patients had an average of nine home visits; 21% were hospitalized, and 59% were seen in the emergency department. Consistent with the program goals, primary care, specialty care, and emergency department visits declined in the year after enrollment, whereas access and quality-of-care targets improved. An academic physician house calls program in partnership with a healthcare system can improve access to care for homebound frail older adults, improve quality of care and patient satisfaction, and provide a positive learning experience for trainees. J Am Geriatr Soc 57:1103-1109, 2009

Original languageEnglish
Pages (from-to)1103-1109
Number of pages7
JournalJournal of the American Geriatrics Society
Volume57
Issue number6
DOIs
StatePublished - Jun 2009

Fingerprint

House Calls
Quality of Health Care
Activities of Daily Living
Geriatrics
Hospital Emergency Service
Home Care Agencies
Delivery of Health Care
Physicians
Frail Elderly
Nurse Practitioners
Medicaid
Budgets
Patient Satisfaction
African Americans
Primary Health Care
Learning
Costs and Cost Analysis

Keywords

  • Home visits
  • House calls
  • Physicians

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

House calls for seniors : Building and sustaining a model of care for homebound seniors. / Beck, Robin; Arizmendi, Alejandro; Purnell, Christianna; Fultz, Bridget A.; Callahan, Christopher.

In: Journal of the American Geriatrics Society, Vol. 57, No. 6, 06.2009, p. 1103-1109.

Research output: Contribution to journalArticle

Beck, Robin ; Arizmendi, Alejandro ; Purnell, Christianna ; Fultz, Bridget A. ; Callahan, Christopher. / House calls for seniors : Building and sustaining a model of care for homebound seniors. In: Journal of the American Geriatrics Society. 2009 ; Vol. 57, No. 6. pp. 1103-1109.
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