Physician house calls – a solution for the elderly?

Physician house calls are a unique modality of care directed towards the frail and chronically ill elderly who are otherwise unable to access care. Home visits are a re-emerging form of healthcare delivery with the aim to minimise re-hospitalisations and support positive ageing at home strategies. The United Kingdom, Denmark and Australia have established national policies, while various localities in the United States, Canada and Europe have piloted preventive house calls projects, some of which have shown a reduction in unnecessary emergency room visits and hospitalisations. Inevitably, as individuals age, disability and morbidity increases. It is becoming increasingly important to find cost-effective solutions to quality care as the costs of healthcare continue to rise. Although house calls offer many benefits and may be rewarding experiences for both the physician and patient, low financial compensation and the time-consuming nature of the visit may deter physicians from providing this type of care in Ireland. Without the provision of house calls, an unmet need for geriatric care evolves. Further economic evaluation is required to determine if house calls are a financially sound solution. In considering house calls, a multidisciplinary approach to physician home visits in Ireland should also be explored, as this modality may deliver more comprehensive and efficient care.