The return of the house call in US

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A relic from the medical past – the house call – is returning to favour in some US hospitals’ palliative care programmes, which are sending teams of physicians, nurses, social workers, chaplains and other workers to patients’ homes after discharge. [s]The New York Times[/s] reports that the goal is twofold: to provide better treatment and to cut costs. Home care is generally cheaper than hospital care and under the [b]Affordable Care Act[/b], Medicare has begun to penalise hospitals when, under certain conditions, patients are readmitted within 30 days after discharge.

Although not a major trend, the movement towards concierge medicine – sometimes known as direct care – is increasing in the US, reports [s]Daily Democrat[/s]. In a post – [b]Affordable Care Act[/b] landscape, some expect a steady trickle of primary care physicians to abandon insurance companies and government regulations for the simplicity of charging patients directly. And more patients who have insurance may decide to also pay an additional fee because they want more one-on-one time.

New technology is helping to move to house calls – with the only thing required a computer, reports [s]WDRB[/s]. ‘We use a video cam or web cam and it creates a face-to-face encounter with a patient,’ says Dr Ben Green. The service isn’t for the chronic or seriously ill but for more common ailments such as, pink eye, a sinus infection or an unshakeable cough.

Doctors in the US are, meanwhile, having to weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care, reports [s]The New York Times[/s]. [b]The American Society of Clinical Oncology[/b], alarmed by the escalating prices of cancer medicines, is developing a scorecard to evaluate drugs based on their cost and value, as well as their efficacy and side effects. And the [b]American College of Cardiology[/b] and the [b]American Heart Association[/b] recently announced that they would begin to use cost data to rate the value of treatments in their joint clinical practice guidelines and performance standards.

Full report in The New York Times
Study abstract
Full Daily Democrat report
Full WDRB report
Full report in The New York Times


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