Why Home-Based Primary Care Has Taken A Backseat Over Expensive Hospitalization?

In today’s high octane lifestyle prevalent in society, it is common to see that healthcare spending in India takes up to 50% of the annual income of the majority of the population.

The patients I am talking about tend to be frail, elderly and have multiple chronic illnesses while many have unmet behavioral and mental health needs as well. Each family has one or two elderly patients who require monthly checkups, prescription refill and blood tests. Come to think of it, home visits to patients is not a bad idea if seen through the eyes of the patient and their families. This not only saves a lot of time and money on hospitalization and miscellaneous hospital bills, but also provides care for the patients where they are most happy (their homes) making it easier for them to recover.

The basic idea is to provide care from the comfort of their homes. This will lead to half the expenditure of what traditional Medicare programs spend on severely sick patients. Much of the savings will result from keeping patients healthy enough to avoid high-cost hospitalizations.

High-cost, high-need patients tend to spend almost all of their time at home. They’re often elderly seniors who live alone. Many lack access to reliable transportation that can get them convenient and in some cases immediate appointments with doctors. Instead of demanding that patients come to us to receive care, what if we went to them?

In doing so, we could eliminate barriers concerning access to quality medical care for the patient and convenience to the worried family members. But for this concept to succeed, we’d have to restore the lost practice of making house calls. After all, gone are the days of charming doctors showing up on doorsteps with medical bags in their hands [Remember the old Hindi movies? Except for the basic services offered by home care agencies, healthcare at home has taken a backseat over the “trend” set by the new mushrooming hospitals’ chains.

The idea is to treat the patients within the comfort of their homes, just as we would in a medical office setting, fine-tune medications, examine & dress wounds and make diagnoses.

But Home-Based Integrated Care is so much more than that. For this idea to succeed, there need to be teams made up of primary care physicians, nurses, case managers, medical assistants, social workers and other professional caregivers who work in tandem to provide comprehensive care to include preventive, chronic conditions, urgent and post-discharge care.

On visiting new patients, the medical professional shall assess their mental and physical health; ensure that they’re filling prescriptions and taking their medications appropriately. For their convenience, we can try to develop a strong relationship with local pharmacies who deliver pre-packaged medications to patients and can ensure timely alterations in medication regimens.

Seeing patients at home adds a certain familiarity to the doctor-patient relationship, which often gives long lasting positive results.