Trends in Physician House Calls to Medicare Beneficiaries

被引:18
|
作者
Peterson, Lars E. [1 ]
Landers, Steven H. [2 ]
Bazemore, Andrew [3 ]
机构
[1] Amer Board Family Med, Lexington, KY 40511 USA
[2] VNA Hlth Grp, Red Bank, NJ USA
[3] Robert Graham Ctr, Washington, DC USA
关键词
Geriatrics; House Calls; Medicare; HEALTH-CARE NEEDS; HOME;
D O I
10.3122/jabfm.2012.06.120046
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: House calls (HCs) to older adults seemed to be headed for extinction in recent decades. HCs may be a tool to ensure access and reduce institutionalization of the elderly population. This study determines the number and distribution of HCs by physician specialty over time and analyzes associations of providing HCs with physician and area-level characteristics. Methods: This study was a cross-sectional analysis of 3 complete Medicare Part B claims data for national state-representative samples of physicians in 2000, 2003, and 2006. Multilevel logistic regression determined associations between physician and area-level characteristics and provision of HCs in 2006. Results: Physicians made 478,088 HCs in 2000; 700,661 in 2003; and 995,294 in 2006. Over the same period, the proportion of physicians making HCs decreased from 7.22 (standard error, +/- 0.20) to 5.26 (+/- 0.19). Physicians in the top decile of HC volume made an increasing number of HCs (median, 56 in 2000 and 86 in 2006). In 2006, physicians who made HCs were more likely to be older, geriatricians, and osteopaths, be in solo practice, and reside in rural areas compared with those who did not make HCs. Conclusions: Between 2000 and 2006, the number of physician HCs to Medicare beneficiaries more than doubled, whereas the number of physicians making HCs declined. (J Am Board Fam Med 2012;25:862-868.)
引用
收藏
页码:862 / 868
页数:7
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