Home-based medical care provides medical care at home to patients with acute or chronic conditions who are frail, functionally limited, or homebound. Home-based medical care has potential to provide improved quality of care and health outcomes, to reduce medical emergencies, missed appointments, fragmented care, the poor control of chronic conditions and cost of health care.
Millions of older Americans are homebound, meaning they never or rarely leave home or leave home only with assistance. A recent study in Health Affairs has identified the number of homebound older adults who received the home-based medical care and determined the sociodemographic, geographic and clinical characteristics with receipt of home-based medical care. In this report, Reckerey and colleagues assessed survey and interview data from the National Health and Aging Trends Study (NHATS) and Medicare claims data. The research team focused on adults aged 65 years or older, including 7,552 community-dwelling, fee-for-service Medicare beneficiaries in the US from 2011 to 2017.
Their study had 2 main findings. First, only 11.26 % homebound older patients (approximately 4.4 million fee-for-service Medicare beneficiaries in 2017) received home-based medical care. Among homebound medicare beneficiaries studied in this report, 7.61%, 8.12%, 7.06%, 9.15%, 7.12%, 10.59% and 7.37% patients received home-based medical care during 2011, 2012, 2013, 2014, 2015, 2016 and 2017 respectively. Second, the receipt of home-based medical care was most common among those living in metropolitan areas or in assisted living facilities, who had impairment in two or more activities of daily living, dementia, received Medical home health care and had greater age.
“Home-based medical care is serving both clinically and socially complex homebound and non-homebound people, but the number of people who may benefit from this care is much greater than the number who receive it.”Source: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.01537
This study assessed how many homebound older adults received home-based medical care and demonstrated gaps in delivery of this care during pre-COVID-19 era . Amid pandemic, the number of homebound patients (both older and younger patients) have increased due to concerns over coronavirus infection. Is delivery of home-based medical care sufficient during the pandemic? Has it changed during the pandemic? Pandemic is creating unique opportunity to answer above questions.