Author Affiliations: Department of Medicine, Boston University School of Medicine, Boston, Mass (Dr Levine); Departments of Medicine and Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY (Dr Boal); and Department of Medicine, Virginia Commonwealth University, Richmond (Dr Boling).
Contempo Updates Section Editor: Sarah Pressman
Lovinger, MD, Fishbein Fellow.
Care at home is an important option for patients with acute or chronic
health problems.1 Home care used appropriately
decreases hospitalization and nursing home use without compromising medical
outcomes. Moreover, patients generally prefer to remain in familiar surroundings.
Physician support of home care services honors that preference.
The term home care refers to any diagnostic,
therapeutic, or social support service provided at home (Box) .2 Home health agency
care is familiar to most physicians. Quiz Ref IDThis includes physical,
occupational and speech therapy, skilled nursing, social work, and home health
aide services; is focused primarily on postacute care; and usually lasts weeks
to months. Home care also encompasses the use of medical equipment, telemedicine
monitoring, and portable diagnostic tools. Technologically intensive
services range from simple intravenous therapy to multidrug preloaded infusion
pumps, hemodialysis, and ventilators. The specialized hospice benefit is another
important home-based service. Long-term supportive care is provided mainly
by personal care aides and lay caregivers. Payers and regulations vary (Table 1).3- 5 Home
medical care involves a physician, physician assistant, or nurse practitioner
who provides acute or chronic care, which can be preventive, diagnostic, therapeutic,
palliative, or rehabilitative.
Levine SA, Boal J, Boling PA. Home Care. JAMA. 2003;290(9):1203-1207. doi:10.1001/jama.290.9.1203