A Novel Health Care Delivery Model-House Call Docs

Presented During:

Sat, 6/13/2020: 1:26 PM  - 1:35 PM 
Webinar  
Room: Webinar  

Final ID:

117 

Authors:

N Golewale1, S Sinha2

Institutions:

1Modern Vascular & Vein Center, Valparaiso, IN, 2House Call Doc, PC, Highland, IN

First Author:

Nazar Golewale, MD  
Modern Vascular & Vein Center
Valparaiso, IN

Co-Author:

Saket Sinha, MD  
House Call Doc, PC
Highland, IN

Presenting Author:

Nazar Golewale, MD  
Modern Vascular & Vein Center
Granger, IN

Purpose:

In 2011, the prevalence of Homebound population was 5.6% of the US population. This population has high disease burden and substantial functional limitations, The purpose of our study is to report our experience in providing primary and specialty care at patient's home in Northwest Indiana.

Materials:

This study was conducted over a 12 month period between August 2018 to August 2019. Post hospitalized and homebound geriatric patients with limited access to healthcare were identified in our region of 30 mile radius. A collaborative house call team consistent of Internists, Vascular Interventional Radiologists (IR) and Podiatrists provided primary and speciality care at patient's home. Laboratory services such as blood draws, urine analysis, drug screening etc were done by dedicated lab team. Imaging services such as ultrasonography and Echocardiography were also made available.

Results:

The group performed over 951 clinical visits for more than a thousand active patients in our practice in the last 1 year. The reason for physician's visit to patient home ranged from routine and preventive care to acute and on going chronic illness management. Diabetic foot evaluation, ingrown toe nail and wound management were performed by Podiatrists with significant control of foot and ankle conditions in this subset of patients. Various image guided procedures performed by IR at home such as ultrasound guided superficial needle biopsy, Gastrostomy tube management, Paracentesis and Thoracentesis, ultrasound guided Joint injections, which otherwise would have required patients to go to hospital setting. Satisfaction score increased from 17% to 84 % from before and after implementation of the program.

Conclusions:

A collaborative house call doctor model is a newer health care delivery approach to provide primary and specialty care at patient's home. Even complex medical conditions and its treatments can be safely and effectively provided at patient's home. Our model has shown significant reduction in health care cost for patients and payors, and demonstrated decline in hospitalization rates in this cohort.

Abstract Categories:

Healthcare Policy

Keywords:

Collaboration
Healthcare cost
Healthcare Disparities