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.