Home visits to the housebound patient in family practice: A multicenter study

Background: Most countries today are experiencing an accelerated pace of po pulation aging. The management of the elderly housebound patient presents a special challenge to the family physician. Objectives: To investigate a series of home visits to housebound patients, the therapeutic procedures used, the equipment needed, and the diagnostic c onclusions reached. Methods: The details of 379 consecutive home visits to housebound patients were recorded by 91 family doctors serving 125,000 patients in Israel. Results: The average age of the patients was 76.1 years. The vast majority of the visits were during office hours (94%). In 24.1% it was the doctor wh o decided to make the home visit on his/her own initiative. The most common initial reason for a home visit was undefined general symptoms, but the do ctor was usually able to arrive at a more specific diagnosis after the visi t. Medications were prescribed in 59.1% of the visits, and in 23.5% the med ication was administered directly by the physician. The commonest drugs use d were analgesics and antibiotics. In 19.3% of visits no action at all, oth er than examination and counseling, was undertaken. The equipment needed in cluded prescription pads (73%), a stethoscope (81%), sphygmomanometer (74.9 %), and otoscope/torch (30.6%). Only 15% of visits resulted in referral to hospital. Conclusions: Home visits to housebound patients serve as a support to careg ivers, provide diagnostic information, and help the family with the decisio n as to when hospitalization is appropriate. The specific medical cause for the patient being housebound had little effect on the process of home visi ting.