Outcomes of Home-Based Primary Care for Homebound Older Adults: A Randomized Clinical Trial

Authors
Alex D. Federman
Abraham Brody
Christine S. Ritchie
Natalia Egorova
Arushi Arora
Sara Lubetsky
Ruchir Goswami
Maria Peralta
Jenny M Reckrey
Kenneth Boockvar
Shivani Shah
Katherine A Ornstein
Bruce Leff
Linda DeCherrie
Albert L Siu
Peer-Reviewed Article
February 2023

Headline

A home-based primary care program reduced hospitalization rates and improved satisfaction of care for homebound older adults.

Background

Home-based primary care can reduce barriers to health care for homebound older adults. This study measures differences in satisfaction with care, quality of life, hospitalizations, and emergency department visits between groups who received either home-based or in-office primary care.

Findings

Participants were randomly assigned to receive home-based primary care or in-office care as part of a program in New York City. Between February 2017 and July 2019, home-based primary care participants had 17% fewer hospitalizations and reported two times higher satisfaction with their care when compared to those in the in-office care group. Advance care planning was also higher for the intervention group, as providers recommended that participants and their caregivers identify and document treatment preferences for future care. The study ended early due to the number of deaths reported in the home-based primary care group; however, these deaths were not attributed to the individuals’ participation in the program.

Policy/Program Takeaways

Home-based primary care can improve acute care outcomes for homebound older adults. This study, as well as this systematic review, can be used by health care providers and health systems interested in implementing this approach within a practice or care team.

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