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At least 19 recordsLinked to original sources
PubMed2003

[The so-called preventive house call. Forestalling nursing home admission].

In view of the increasing numbers of elderly citizens in the general population, there is a need to ensure that they receive medical care within a setting of independence preservation and, wherever possible, within the domestic environment. Preventive house calls can contribute greatly to efforts made to achieve this aim. The implementation of this effective instrument should be in the hands of a team of specially trained family doctors, nurses and geriatric care-providers. During a house call, a multidimensional geriatric assessment covering such aspects as mobility, nutritional status, somatosensory status, and domestic and social environment, should be made. Of essential importance is the long-term care of the geriatric patient, which can be realized by the family doctor via repeated house calls. Current cost/benefit analyses clearly favor anchoring the preventive house calls in the public health service.

Activities of Daily Living↗
PubMed1991

Therapy begins at home: the psychiatric house call.

The house call is a valuable but underused component of community psychiatric care. A review of home visits conducted by the staff of a community mental health service over a 12 month period identified four situations in which a home visit is useful: getting reluctant patients to enter therapy, conducting a comprehensive assessment, strengthening a support network, and maintaining patients in the community when their condition has deteriorated. Making psychiatric house calls requires some additional skills on the part of therapists and offers residents valuable training experience.

Aged↗
PubMed1995

House calls for respiratory tract infections; family medicine pure and simple?

House calls still seem to be an important element in the work of general practitioners in the Netherlands. A secondary analysis of the data of the Netherlands Institute of Primary Health Care (NIVEL) National Study of Illnesses and Procedures reveals that 15% of the contacts relating to cases of respiratory tract infections are house calls. General practitioners appear to consider carefully whether or not to make house calls. House call figures differ considerably with respect to diagnosis, reasons for encounter and age. Relatively high percentages of house calls occur in cases of lower respiratory tract infections, fever as reason for encounter, for old people and young children. The number of house calls is hardly associated with region, level of urbanization and distance from a hospital. Further research is necessary to establish guidelines for the decision whether or not to make a house call.

Aged↗
PubMed1981

The house call in current medical practice.

There is currently a resurgence of interest in house calls in American primary care. Studies have shown that at least 53 percent of family physicians still do house calls, although younger physicians may be less likely to do house calls than their older colleagues. To gain a deeper insight into the house call, one must appreciate the types of house calls: (1) the emergency house call, (2) the acute illness house call, (3) the chronic illness house call, (4) the dying patient house call, (5) the house call to pronounce death, (6) the grief house call, (7) home management vs hospitalization house call, and (8) the home visit house call. The chronic illness house call is by far the most common type, but all can become important ingredients in comprehensive family practice. The training environment should emphasize the home visit type of house call, since one must learn to appreciate this type of encounter.

Family Practice↗
PubMed1984

Nonemergency forensic psychiatric house calls.

Recent literature on medical house calls in general is not extensive, and that on nonemergency forensic psychiatric calls in particular is nearly nonexistent. Two cases of nonemergency forensic psychiatric house calls are described in this communication; it is our contention that they led the psychiatrist to a better appraisal of the person's capacity to perform than would have been expected from office visits. One situation involved testamentary capacity; the other, possible abrogation of parental rights. In our estimation the individual, as well as the legal system, would benefit if this type of house call were promoted.

Adult↗
PubMed1977

House call patterns of New Jersey family physicians.

House call attitudes and practice patterns of New Jersey family physicians were studied in order to assist residency programs in curriculum development. House calls were offered by 82 percent of the 290 physicians in the sample; no difference was noted between rural and urban or between younger and older physicians. The average number of house calls per week was 6.05, of which 4.71 and 1.34 were scheduled and emergency respectively. Patients who were elderly, home-bound, had suffered a stroke, had cancer or congestive heart failure made up the majority of those receiving house calls. This survey also showed that many of the physicians who stated that they do not "offer" house calls to their patients, did in fact perform them. These study results support the thesis that family practice residencies should develop criteria and a protocol for house calls. Among the results which may be expected following such an innovation are increased satisfaction for patients and physicians alike.

Adult↗
PubMed2006

An analysis of patient house calls in the area of Attica, Greece.

BACKGROUND: Physicians house calls to patients have been declining in many countries of the world. The objective of this study was to describe the patterns of utilization of house call services provided by SOS doctors in the area of Attica, Greece. METHODS: We performed a retrospective analysis of data regarding house call visits of patients in the area of Attica (metropolitan area of Athens and surrounding cities), Greece. Characteristics of patients who received house call services by a physician, including diagnosis, and recommended management plan, including advice for hospitalization were analyzed. RESULTS: SOS doctors in the area of Attica, Greece performed 98,009 house calls during the 5-year study period (1/11/2000-31/10/2005). Patients older than 65 years requested 47.8% of the house calls. Females requested more house calls during the studied period compared to males (59.4% versus 40.6%, p < 0.001). The majority of the diagnoses (18.4%) were infections of the upper and lower respiratory tract. 9.1% of patients were advised after the evaluation at home to be admitted to a hospital to receive inpatient services. CONCLUSION: Our analysis documents the utilization of house calls by SOS doctors in the area of Attica, Greece during a 5-year period. We believe that house calls provided by individual practitioners, physician group practices, or organized companies and organizations should re-gain their well-deserved position in the modern health care systems.

Adolescent↗
PubMed1994

House call practices: a comparison by specialty.

BACKGROUND: There has been no national survey of physician house calls since 1980, and in particular, no survey of pediatric house calls in 30 years. This national study was undertaken to compare physician house call practices among family physicians, general internists, and general pediatricians. METHODS: A mail survey was conducted of 1500 primary care physicians who were randomly selected from the American Medical Association Physician Master File. Five hundred physicians were selected from each of three specialties: family medicine, internal medicine, and pediatrics. RESULTS: Nine hundred six questionnaires were returned for a response rate of 59%. The percentage of family physicians making house calls was significantly greater than that of internists or pediatricians (63%, 47%, and 15%, respectively). Factors associated with making house calls were: house calls being a common practice in the community, solo practice, specialty (family practice), sex (male), and practice location in the northeast. Physicians who agreed with the following attitudes were more likely to make house calls: (1) making house calls leads to high patient satisfaction; (2) house calls are important for good comprehensive patient care; and (3) house calls are satisfying for physicians. Physicians who agreed that making house calls exposes them to a significant malpractice risk were half as likely to make house calls. CONCLUSIONS: Family physicians made significantly more house calls than internists or pediatricians.

Attitude of Health Personnel↗
PubMed1992

[Characteristics of urgent house calls in an urban clinic].

Urgent house calls during regular clinic hours constitute a significant burden on the family physician's workload. It is the impression of the staff of this clinic that many patients use this service incorrectly, so that ordering an urgent house call often leads to a direct confrontation between the patient and his physician. During a 4-month period questionnaires were filled out by the physician before and after every visit described as "urgent" by the caller. There was a huge gap between the physician's and the patient's concept of what constitutes an urgent situation. However, in many cases the physician justified the visit. This survey emphasizes the importance of house calls and justifies them, but not always as to their urgency. As a result of this survey, we are now designing a program to improve communication when an urgent house call is ordered, in order to minimize the gap between the physician's and his patient's understanding and expectations of the necessity and urgency of the visit.

Aged↗
PubMedDate not supplied

Factors associated with the frequency of house calls by primary care physicians.

OBJECTIVE: To evaluate factors associated with the frequency of house calls by primary care physicians. DESIGN: A cross-sectional design with a self-administered mailed survey. SITTING/PARTICIPANTS: 751 primary care physicians who care for Medicaid patients in Virginia. RESULTS: Among 389 physician respondents (52%), regular house callers (n = 216) were compared with occasional house callers (n = 162). Among physician characteristics, specialty and practice duration were associated with house call frequency. Regular house callers also more often cited chronic illness (67% vs. 20%, p less than 0.01) and terminal illness (67% vs. 40%, p less than 0.01) as indications for house calls, compared with occasional house callers. Use of visiting nurses to substitute for physician house calls was less often considered appropriate by frequent house callers (7% vs. 24%, p less than 0.01), and regular house callers were less likely to report being "too busy" to make house calls (71% vs. 29%, p less than 0.01). Multivariate analysis confirmed the association of these attitudes with house call frequency. CONCLUSION: These data suggest that specific attitudes among primary care physicians are associated with house call frequency.

Adult↗
PubMed1986

House calls by New Hampshire family practitioners.

We surveyed current activities and attitudes regarding house calls among New Hampshire family physicians. Fifty of a random sample of 72 eligible participants returned a brief questionnaire. They reported on 134 house calls they made during the two weeks prior to the survey. Eighty-four percent of participants offered house calls, averaging 2.68 house calls per physician over the two week study period. Most house calls were to the elderly or homebound for management purposes. Physicians thought house calls were important, but often an inefficient use of their time. Financial and time constraints were the most commonly cited limiting factors. The decision to make a house call is based on clinical judgment regarding the individual case and broader issues involving the physician's whole practice. Unless external constraints change, house calls will continue to be an uncommon event.

Adult↗
PubMed1991

The house call in residency training and its relationship to future practice.

The aging of the population makes education in geriatrics vital to family practice residents, including training in house calls. This study examined the relationship of house call training in residency with current house call practices of recent graduates of family practice residencies. A questionnaire mailed to a random national sample of 301 family physicians who completed residency training between 1981 and 1986 obtained a 66% response rate with three mailings. House calls were not required in the curriculum for 80% of respondents, 30% never did house calls in residency, and 55% recognized they were not well trained in house calls. Graduates of programs in which faculty made house calls and those in which residents made house calls on a longitudinal basis were significantly more likely to offer house calls in their practices. This suggests that resident education can offer positive experiences in house call training to encourage future physicians to include house calls in their practices.

Family Practice↗
PubMed1989

House call practices among young family physicians.

Once a major part of medical practice, physician house calls have declined in frequency over the years. Recently, it has been suggested that house calls are increasing. This study examined the current self-reported house call practices among recent graduates of family practice residency programs in the United States. A questionnaire was mailed to a cross-sectional, random national sample of 301 family physicians who are members of the American Academy of Family Physicians and who completed a residency between 1981 and 1986. There was a 66% response rate to three mailings, with 197 questionnaires analyzed. Sixty-two percent of the physicians reported they were making house calls. The majority (53%) made less than one house call per month. Fewer than 15% made house calls on a weekly basis. There was a downward trend by residency year in the percentage of physicians making house calls when comparing graduates from 1981 to 1986. House calls do not appear to be a significant part of the practice of young family physicians.

Adult↗
PubMed1985

House calls: current status and rationale.

House calls play a limited but important role in modern family practice. Family physicians make an average of two to six home visits a week for various reasons, including acute illness, terminal care, death pronouncement and hospital follow-up. The rationale for house calls includes enhancing the doctor/patient relationship, providing medical therapy, evaluating and reinforcing the patient's support system, and making an ecologic or family assessment.

Aftercare↗
PubMed1999

The family physician and house calls. A survey of Colorado family physicians.

BACKGROUND: Visiting patients at home has long been one of the activities of the family physician, but the practice of making house calls has diminished significantly during the second half of the 20th century. The goal of this study was to describe physicians' attitudes about house calls and their practice of making them in the rapidly changing health care environment of the United States. METHODS: A 30-item, self-administered questionnaire was designed to obtain demographic information about physicians and their attitudes toward house calls, practice experiences with making house calls, and any additional factors that influence making house calls. It was mailed to all members of the Colorado Academy of Family Physicians, during the summer of 1997. RESULTS: A 66% response rate was obtained from practicing physicians. Overall attitudes toward house calls were positive. Fifty-three percent of the respondents reported making house calls, and 8% reported making more than 2 house calls per month. Male physicians, those older than 40 years, those in rural settings, and those trained in a community-based residency were more likely to make house calls. Patient payer mix and practice setting were also related to whether a physician made house calls. House calls were most frequently made to geriatric patients, cancer patients, trauma patients, and patients with transportation difficulties. Many physicians reported using home health agencies for assessment and treatment of patients needing home care. CONCLUSIONS: Family physicians agree that house calls are good for patients. More than half of the respondents reported that they occasionally make house calls. However, few physicians routinely perform house calls.

Adult↗
PubMed2001

House calls: is there an APN in the house?

PURPOSE: To report how a group of geriatric advanced practice nurses (APNs) participated in a house calls program that increased access to care for homebound and frail community-dwelling elders. DATA SOURCES: Selected literature and author experiences, illustrated with clinical examples. CONCLUSIONS: Many frail older adults are unable to access healthcare due to functional impairments related to multiple, chronic medical conditions. Many of these adults inappropriately utilize the emergency department for episodic care. IMPLICATIONS FOR PRACTICE: The model of care maximizes utilization of APNs to provide cost effective, culturally sensitive, quality care. The goal of geriatric assessment and primary care in this practice is to add quality to later years of life, promoting dignity and comfort to older adults and their families.

Aged↗
PubMed1993

Crisis intervention on a house call: a family doctor's way.

Having made over 50,000 house calls during his lengthy career, the author writes of a special house call. The author uses this house call as a learning experience by relating the events that took place during the house call. The lesson to learn is that the physician can heal a patient in many ways.

Adolescent↗