Attitudes, perceptions and practice patterns of primary care practitioners towards house calls

Abstract

ABSTRACT INTRODUCTION Historically, doctors routinely delivered medical care to sick patients in their homes, with house calls accounting for 40% of all doctor–patient encounters in the 1940s. This proportion has dwindled to less than 1% today. Advantages of house calls include decreased mortality rates, admissions to long-term care in the general elderly population and increased patient appreciation. Therefore, we asked ‘Why do some primary care practitioners do house calls and what are the reasons that others do not?’. AIM This review aims to understand the attitudes, perceptions of Primary Care Practitioners (PCPs) towards house calls and their practice patterns. METHODS A search of PubMed and Embase was conducted for articles published before 31 December 2017. A total of 531 articles with 44 duplicates was generated. Of these, 13 were shortlisted along with three hand-searched articles for a total of 16 articles included in this review. RESULTS Primary care providers were aware of the role of house calls and their advantages in enabling comprehensive care for a patient. They saw making house calls as a responsibility with rewards that enhanced the doctor–patient relationship. However, opportunity cost, time, medical liability and miscellaneous reasons such as the lack of training precluded some PCPs from making more house calls. DISCUSSION Primary care practitioners recognise the importance of house calls, especially in the care of elderly patients, but there are many unaddressed issues such as opportunity cost and clinical inadequacy in the home setting that have caused a decline in house calls over the years.