TY - JOUR
T1 - Population Health and Tailored Medical Care in the Home
T2 - the Roles of Home-Based Primary Care and Home-Based Palliative Care
AU - Ritchie, Christine S.
AU - Leff, Bruce
N1 - Funding Information:
The authors have no financial or any other kind of personal conflicts with this study. Dr. Leff is a member of the Board of Directors of the American Academy of Home Care Medicine. Bruce Leff and Christine Ritchie were funded by the Commonwealth Fund , Retirement Research Foundation . This work was supported by the Commonwealth Fund, a national private foundation based in New York City that supports independent research on health care and makes grants to improve health care practice and policy. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund, its directors, officers, or staff.
Publisher Copyright:
© 2017 American Academy of Hospice and Palliative Medicine
PY - 2018/3
Y1 - 2018/3
N2 - With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background—home-based primary care (HBPC) and home-based palliative care (HBPalC). Although the type of services provided by HBPC and HBPalC (together termed “home-based medical care”) overlap, HBPC tends to encompass longitudinal and preventive care, while HBPalC often provides services for shorter durations focused more on distress management and goals of care clarification. Given workforce constraints and growing demand, both HBPC and HBPalC will benefit from working together within a population health framework—where HBPC provides care to all patients who have trouble accessing traditional office practices and where HBPalC offers adjunctive care to patients with high symptom burden and those who need assistance with goals clarification. Policy changes that support provision of medical care in the home, population health strategies that tailor home-based medical care to the specific needs of the patients and their caregivers, and educational initiatives to assure basic palliative care competence for all home-based medical providers will improve access and reduce illness burden to this important and underrecognized population.
AB - With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background—home-based primary care (HBPC) and home-based palliative care (HBPalC). Although the type of services provided by HBPC and HBPalC (together termed “home-based medical care”) overlap, HBPC tends to encompass longitudinal and preventive care, while HBPalC often provides services for shorter durations focused more on distress management and goals of care clarification. Given workforce constraints and growing demand, both HBPC and HBPalC will benefit from working together within a population health framework—where HBPC provides care to all patients who have trouble accessing traditional office practices and where HBPalC offers adjunctive care to patients with high symptom burden and those who need assistance with goals clarification. Policy changes that support provision of medical care in the home, population health strategies that tailor home-based medical care to the specific needs of the patients and their caregivers, and educational initiatives to assure basic palliative care competence for all home-based medical providers will improve access and reduce illness burden to this important and underrecognized population.
KW - Home-based primary care
KW - home-based palliative care
KW - population health
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U2 - 10.1016/j.jpainsymman.2017.10.003
DO - 10.1016/j.jpainsymman.2017.10.003
M3 - Article
C2 - 29031914
AN - SCOPUS:85039938123
SN - 0885-3924
VL - 55
SP - 1041
EP - 1046
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 3
ER -