The involvement of physicians in VA home care: Results from a national survey

OBJECTIVES: To examine the role of physicians in the Veteran Affairs (VA) h ome-based primary care (HBPC) program and to identify variables that predic t whether physicians make home visits and volume of home visits made. DESIGN: Descriptive and regression analyses of responses from a mail survey . PARTICIPANTS: Forty-five physicians affiliated with VA HBPC programs. MAIN SURVEY TOPICS: Self-reported work load, attitudes toward home care, re asons for home visits, administrative policies regarding physicians' role i n patient care management, and time commitment to home care. RESULTS: A majority of physicians believed strongly in the importance of ho me care and made home visits for reasons consistent with their training. Ph ysician attitude toward home care and preoccupation with office or hospital practice were related to whether or not physicians made home visits. Degre e of preoccupation with office practice and amount of salary support from V A HBPC were significant predictors of the number of visits made (R-2 = 0.44 ). CONCLUSIONS: These findings indicate that most physicians will make home vi sits if they believe that home care is valuable and if their time commitmen t is supported financially. Managed care plans that own and operate home ca re programs and have the capacity to transfer primary care management to ph ysicians who derive financial support from the programs should find this in formation particularly relevant.