An article that appeared in the Los Angeles Times in late August looked at the idea that one of the keys to providing better medical care at lower costs may be house calls.
Should we bring house calls back?
There is some compelling data — like an in-home doctors’-visit program for Medicare patients at the Virginia Commonwealth University Medical Center that cut the length of hospital stays and saved the hospital millions of dollars. A similar program through the Department of Veterans Affairs cut hospital inpatient admissions by more than one-quarter, and total days in the hospital by more than two-thirds.
Elderly patients with multiple conditions who have trouble getting to their doctor’s office are often more likely to end up in the hospital. It’s worth noting that the sickest 10 percent of Medicare recipients account for two-thirds of total spending. In-home visits could take the place of unnecessary and costly hospital stays and help prevent equally expensive re-admissions to the hospital.
But home visit programs require an upfront financial commitment to achieve long-term savings, which Medicare has been reluctant to fund. Many doctors who want to incorporate home visits in their practice can’t afford to.
Politicians in the health reform discussion have proposed increasing funding to house call programs. For the sake of keeping our seniors healthy, let’s hope this funding survives the debate.
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