Home-Based Primary Care for Older Adults: Matched Case-Control Evaluation of Program's Impact on Healthcare Utilization.
| Autor: | Kling, Samantha M. R., Garvert, Donn W., Lessios, Anna Sophia, Yefimova, Maria, Martin, Marina, Sheffrin, Meera, Winget, Marcy |
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| Předmět: |
HOSPITALS
EVALUATION of human services programs HEALTH services accessibility ACADEMIC medical centers FRAIL elderly COVID-19 OUTPATIENT medical care HOSPITAL emergency services HOME care services CASE-control method REGRESSION analysis FISHER exact test ACTIVITIES of daily living PRIMARY health care MEDICAL care use HUMAN services programs PRE-tests & post-tests T-test (Statistics) RESEARCH funding DESCRIPTIVE statistics CHI-squared test HOSPITAL care of older people SECONDARY care (Medicine) MEDICAL appointments DATA analysis software SOCIAL case work LONGITUDINAL method MIDDLE age OLD age |
| Zdroj: | Home Health Care Management & Practice; Aug2023, Vol. 35 Issue 3, p213-221, 9p |
| Abstrakt: | Home-based Primary Care (HBPC) is an alternative model for homebound older adults. Healthcare utilization in HBPC was evaluated with a matched case-control design. Medical providers and social workers provided in-home visits. Enrolled patients were matched to controls on age, prior hospitalizations, and frailty risk. Difference-in-differences in utilization of primary care, specialty, and hospital services between 1-year pre- and 1-year post-enrollment were evaluated with hierarchical linear models. Analyses included 117 HBPC cases and 328 controls. HBPC cases had a significant increase in primary care visits compared to controls (7.8 ± 0.6; p <.0001) but significantly decreased utilization of in-clinic primary care visits (−3.2 ± 0.6; p <.0001). In-clinic specialty visits and hospital services did not differ between cases and controls (all p's ≥.75). Homebound patients accessed high-touch primary and social care, which is typically unachievable in clinic settings; however, additional work is needed to optimize services and target in-home care to impact healthcare utilization. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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