Abstract
Objective:To evaluate factors associated with the frequency of house calls by primary care physicians.
Design:A cross-sectional design with a self-administered mailed survey.
Setting/participants:751 primary care physicians who care for Medicaid patients in Virginia.
Results:Among 389 physician respondents (52%), regular house callers (n=216) were compared with occasional house callers (n=162). Among physician characteristics, specialty and practice duration were associated with house call frequency. Regular house callers also more often cited chronic illness (67% vs. 20%, p<0.01) and terminal illness (67% vs. 40%, p<0.01) as indications for house calls, compared with occasional house callers. Use of visiting nurses to substitute for physician house calls was less often considered appropriate by frequent house callers (7% vs. 24%, p<0.01), and regular house callers were less likely to report being “too busy” to make house calls (71% vs. 29%, p<0.01). Multivariate analysis confirmed the association of these attitudes with house call frequency.
Conclusion:These data suggest that specific attitudes among primary care physicians are associated with house call frequency.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American College of Physicians. Home health care. Position paper. Ann Intern Med. 1986;105:484–90.
Goldsmith B. House calls: anachronism or advent? Public Health Rep 1979;94:299–304.
Keenan JM, Bland CJ, Webster L, Myers S. The home care practice and attitudes of Minnesota family physicians. J Am Geriatr Soc. 1991, in press.
Schueler MS, Harris DL, Goodenough GK, Collette L. House calls in Utah. West J Med. 1987;147:92–4.
Office of Statistics and Data Management, Bureau of Data Management and Strategy, Health Care Financing Administration, Department of Health and Human Services. Part B Medicare annual data system. Undated.
Stone RI, Murtaugh CM. The elderly population with chronic functional disabilty: implications for home care eligibility. Gerontologist. 1990;30:491–6.
Siegel AD. Home health care. Owings Mills, MD: National Health Publishing Co., 1987;163–207, 329–66.
Knight AL, Adelman AM, Sobel J. House call practices among young family physicians. J Fam Pract. 1989;29:638–42.
Warburton SW, Sadler GR, Eikenberry EF. House call patterns of New Jersey family physicians. J Fam Pract. 1977;4:933–8.
Boling PA, Retchin SM, Ellis J, Pancoast SA. The influence of physician specialty on housecalls. Arch Intern Med. 1990;150:2333–7.
Dillman DA. Mail and telephone surveys: the total design method. New York: Wiley Publishers, 1978.
Haldane JBS. The estimation and significance of the logarithm of a ratio of frequencies. Ann Hum Genet. 1956;20:309–11.
Kleinbaum DG, Kupper LL, Morgenstern H. Epidemiologic research: principles and quantitative methods. Belmont, CA: Lifetime Learning Publications, 1982;477–91.
Glantz SA. Primer of biostatistics. New York: McGraw-Hill, 1981;87–8.
Keenan, JM, Fanale JE. Home care: past, present, problems and potential. J Am Geriatr Soc. 1989;37:1076–83.
Burton JR. The house call: an important service for the frail elderly. J Am Geriatr Soc. 1985;33:291–3.
Council on Scientific Affairs, American Medical Association. Home care in the 1990’s. JAMA. 1990;230:1241–44.
Special report. Academic medicine for the year 2000: an institute of medicine report. N Engl J Med. 1987;316:1425–8.
Edwards W, Berlin M. Questionnaires and data collection methods for the Household Survey and the Survey of American Indians and Alaska Natives. National Medical Expenditure Survey methods. 2. Rockville, MD: National Center for Health Services Research and Health Care Technology Assessment. DHHS Publication No. (PHS) 89-3450, 1989.
Young MJ, Bresnitz EA, Strom BL. Sample size nomogram for interpreting negative clinical studies. Ann Intern Med. 1983;99:248–51.
Languillo E. Home care services as teaching sites for geriatrics in family medicine residencies. J Med Educ. 1988;63:667–74.
Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology: the essentials. Baltimore, MD: Williams & Wilkins, 1988;208–5.
Reuben DB, Fink A, Vivell S, Hirsch SH, Beck JC. Geriatrics in residency programs. Acad Med. 1990;65:382–7.
Nieman LK, Jones JG. Family medicine home visit programs in U.S. and Canadian medical schools. J Med Educ. 1983;58:934–40.
Young R, Freiberg E, Stringham P. The home visit in the multidisciplinary teaching of primary care physicians. J Med Educ. 1981;56:341–51.
McCahan JF, Bissonnette AM, DiRusso BA. A house call teaching program for fourth-year medical students. J Med Educ. 1983;58:349–51.
Page AEK, Bartnick LW, Taler GA, Snow DA, Wetheimer DS, Allbrahim MS. A program to teach house calls for the elderly to fourth-year medical students. J Med Educ. 1988;63:51–8.
Sankar A, Becker SL. The home as a site for teaching gerontology and chronic illness. J Med Educ. 1985;60:308–13.
Billings JA, Coles R, Reiser SJ, Stoeckle JD. A seminar in ‘plain doctoring’. J Med Educ. 1985;60:855–9.
Siu AL, Ke GY, Beck JC. Geriatric medicine in the United States: the current activities of former trainees. J Am Geriatr Soc. 1989;37:272–6.
Author information
Authors and Affiliations
Additional information
Supported in part by a grant from Virgina Commonwealth University.
Rights and permissions
About this article
Cite this article
Boling, P.A., Retchin, S.M., Ellis, J. et al. Factors associated with the frequency of house calls by primary care physicians. J Gen Intern Med 6, 335–340 (1991). https://doi.org/10.1007/BF02597433
Issue Date:
DOI: https://doi.org/10.1007/BF02597433