Headline
Literature review of nearly 90 articles on home-based primary care identifies themes for enhancing care quality.
Background
Research on home-based primary care has increased over the past 15 years. This review explored 87 articles published between 2010-2020 and identified themes present throughout the studies.
Findings
Five themes were identified following a review of the articles:
- Provision of home-based primary care – Mental health care emerged as the most frequently integrated subspecialty, and the inclusion of pharmacist consultations was associated with increased medication prescribing.
- Composition of home-based primary care teams – Interdisciplinary teams were found to be common, particularly for patient at highest risk of hospitalization, and were found to be associated with high patient satisfaction and reduced cost, including hospitalization utilization.
- Outcomes – Home-based primary care was found to improve patient satisfaction and quality of care, while reducing costs of care and acute and long-term care utilization. Caregivers were found to also benefit from the intervention.
- Telehealth – Remote patient monitoring may improve care between visits, but barriers emerged, such as digital literacy and access to technology.
- Emergency preparedness in home-based primary care – Studies are needed to understand the role of this care model in responding to disasters and potential evacuations for homebound patients.
The authors also present policy opportunities to improve access to home-based primary care.
Policy/Program Takeaways
Home-based primary care interventions have adaptable scopes, including the use of interdisciplinary team models and telehealth, that can result in improved patient- and system-level outcomes. State policymakers and providers can use this review and included policy recommendations to expand and improve program implementation.