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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↗

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↗

PubMed1978

The psychiatric house call.

Although caregivers in many disciplines have provided home visits as part of their services, psychiatrists have rarely made house calls. The author discusses some of the practical and emotional issues that have traditionally caused both patient and psychiatrist sufficient discomfort to limit this model of therapeutic intervention. Special emphasis is made in support of the psychiatric house call for elderly persons.

Aged↗

PubMed1977

Physician house calls: a complement to hospital-based medical care.

A physician-oriented, hospital-based Home Care Program (HCP) is described. The staff includes a director, resident physicians, nurses, social workers, and clerical personnel. House calls are made by resident physicians during off-duty hours, but patients, their families, and other health professionals may help with their care. Drugs, equipment and supplies are available through the hospital and contract vendors. The most common medical diseases are cardiac and cerebrovascular disorders, arthritis, diabetes mellitus, chronic pulmonary disorders and hypertension. Of 513 patients evaluated in one year, 337 were admitted to the HCP. Two-thirds were women. Ages ranged from 18 to 106 (median, 68 years). Under the HCP there was significant improvement and control of the medical problems, and a decrease in hospital and emergency room admissions, and clinic visits; 207 of the 337 patients were discharged. The HCP cost less than other outpatient and inpatient services. It proved to be a rewarding, economical and effective means of improving medical care for a metropolitan population dependent upon hospital-based physicians for medical services.

Adolescent↗

PubMedDate not supplied

Advance directives among patients in a house call program.

BACKGROUND: Advance medical directives (the living will and the durable power of attorney) provide a means for competent persons to influence treatment decisions in the event of serious illness and loss of competence. Advance directives among elderly homebound patients. METHODS: In a house call program for 120 elderly patients, a standardized telephone interview was conducted with 116 patients or their caregivers. They were asked whether they had a will, a living will, or had assigned a durable power of attorney. Those without advance directives were asked whether they knew what each directive was. Demographic and medical data were assessed by interview and chart review. RESULTS: More than 60 percent of the patients knew about the durable power of attorney, and more than one-half had assigned a durable power of attorney. About one-third knew about living wills, but only 5 percent had one. One-third of the patients had a will. CONCLUSIONS: Advance directives are important mechanisms whereby patients can extend autonomy over the circumstances of dying. Physicians and patients should consider and discuss the issues that surround treatment in the event of terminal illness or permanent unconsciousness.

Activities of Daily Living↗

PubMed1979