House call

A house call is medical consultation performed by a doctor or other healthcare professionals visiting the home of a patient or client,[1] instead of the patient visiting the doctor's clinic or hospital. In some locations, families used to pay dues to a particular practice to underwrite house calls.[2]

History

In the early 1930s, house calls by doctors were 40% of doctor-patient meetings. By 1980, it was only 0.6%.[3] Reasons include increased specialization and technology. In the 1990s, team home care, including physician visits, was a small but growing field in health care, for frail older people with chronic illnesses.

The reasons for fewer house calls include concerns about providing low-overhead care in the home, time inefficiency, and inconvenience. Yet, there are more and more doctors who like the idea of no office overhead. Also, it can provide safe access to care by people who are ill.[4] Today, house calls may be making a revival among the wealthy through concierge telemedicine and mobile apps like Heal.[5][6]

Canada

In 2012 as part of its Action Plan for Healthcare[7] the province of Ontario actively expanded funding for access to house calls with its primary focus being on seniors and those with physical limitations making it difficult for travel outside the home.[8] Residents of Ontario with valid Ontario Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home. Currently, this service is only available in Toronto.[9]

United States

In the United States, leadership such as George Washington were known to receive house calls. Upon his deathbed in 1799, President Washington received a house call prior to his passing.[10] Presently, the United States' leadership retain a Physician to the President on staff.[11]

Midwifery

The US rate of out-of-hospital birth has remained steady at 1% of all births since 1989, with data from 2007 showing that 27.3% of the home births since 1989 took place in a free-standing birth center and 65.4% in a residence.

Outcomes

A 2007 randomized trial of in-home palliative care demonstrated increased patient satistifaction and decreased costs.[12][13]

USSR and post-Soviet Russia

In the Soviet Union the national government established a nationwide free outpatient polyclinic system, where each health center covered a part of a city, a neighbourhood, and this system has been preserved in post-Soviet times. Each general practitioner (therapeut) out of some 10 to 20 working in each state outpatient health centre serves his patients on weekdays both in his room during his 3–4 reception hours and spends another 3–4 hours on house visits (which become most numerous during flu and colds epidemics and can reach 40 per day) on his assigned block of streets with a standard number of residents. Unlike Soviet times, however, each patient now has to produce apart from his citizen ID (pasport with place of residence stamp showing his registration on the clinic's precinct) a now uniform medical insurance policy of obligatory medical insurance provided by a number of medical insurance companies through either financing by employers for working people or by the state – for children as well as old age and disability pensioners through regional funds of medical insurance.

The purpose of such visit is primary diagnostics and prescription of treatment and mode of conduct as well as prescribing blood, urine and other tests to be carried out at the polyclinic. The doctor also supplies the patient with a sick leave from work or study for a number of days and the leave is to be closed by the same doctor or his/her substitute and sealed at the clinic on the patient's recovery and checkout. If need be, the GP may arrange a visit to the sick person from one of specialist physicians from his/her clinic and of his/her nurse for giving injections.

There are two identical state systems of outpatient clinics running parallel – for adults and for children.

With the rise of private enterprise since 1990, city dwellers may place a phone order for a house call from a private medical facility (to be paid for out of patient's own money).

See also

References

  1. ↑ Encarta ® World English Dictionary © & (P) 1998-2004 Microsoft Corporation. All rights reserved.
  2. ↑ Twain, Mark. (1905 & editor commentary 2010 & 2001) Autobiography of Mark Twain, The Complete and Authoritative Edition, Volume 1. Berkeley, CA: University of California Press. ISBN 9780520267190
  3. ↑ Kao, Helen; Conant, Rebecca; Soriano, Theresa; McCormick, Wayne (February 2009). "The Past, Present, and Future of House Calls". Clinics in Geriatric Medicine. 25 (1): 19–34. doi:10.1016/j.cger.2008.10.005. PMID 19217490.
  4. ↑ Leff, Bruce, MD; Burton, John R. (2001) The Future History of Home Care and Physician House Calls in the United States. The Gerontological Society of America: Journal of Gerontology: MEDICAL SCIENCES 2001, Vol. 56A, No. 10, M603–M608 Oxford University
  5. ↑ "Concierge telemedicine, the future house call". 2015-02-27. Archived from the original on 2015-02-27. Retrieved 2015-02-27.
  6. ↑ http://pages/hit-consultant-llc/302199219847409 (2015-06-24). "Heal Nabs $5M for On-Demand Doctor Visits". Archived from the original on 2019-02-14. Retrieved 2019-03-13.
  7. ↑ "Ontario's Action Plan for Healthcare" (PDF). Archived (PDF) from the original on 2014-03-20. Retrieved 2014-07-28.
  8. ↑ "Ontario Expanding House Call Services". 2012-12-11. Archived from the original on 2014-06-13. Retrieved 2014-07-28.
  9. ↑ "Patients - House Calls". Archived from the original on 2014-07-28. Retrieved 2014-07-28.
  10. ↑ "Archived copy". Archived from the original on 2017-12-27. Retrieved 2019-03-15.{{cite web}}: CS1 maint: archived copy as title (link)
  11. ↑ Mishori, Dr Ranit (2009-08-16). "When The Patient Is The President". Parade: Entertainment, Recipes, Health, Life, Holidays. Archived from the original on 2021-10-01. Retrieved 2021-10-01.
  12. ↑ Brumley, Richard; Enguidanos, Susan; Jamison, Paula; Seitz, Rae; Morgenstern, Nora; Saito, Sherry; McIlwane, Jan; Hillary, Kristine; Gonzalez, Jorge (July 2007). "Increased satisfaction with care and lower costs: results of a randomized trial of in-home palliative care". Journal of the American Geriatrics Society. 55 (7): 993–1000. doi:10.1111/j.1532-5415.2007.01234.x. ISSN 0002-8614. PMID 17608870. S2CID 38732453. Archived from the original on 2020-10-28. Retrieved 2020-11-22.
  13. ↑ Federman, Alex D.; Soones, Tacara; DeCherrie, Linda V.; Leff, Bruce; Siu, Albert L. (2018-08-01). "Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program With Clinical Outcomes and Patient Experiences". JAMA Internal Medicine. 178 (8): 1033–1040. doi:10.1001/jamainternmed.2018.2562. ISSN 2168-6106. PMC 6143103. PMID 29946693. Archived from the original on 2020-11-29. Retrieved 2020-11-22.
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