Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

6 major myths about health care at home debunked

Michael Fleming, MD
Physician
September 19, 2014
Share
Tweet
Share

As every physician already knows full well, health care services delivered to the home rather than in an institutional setting are increasing, a trend destined to expand even faster in the decades ahead.

This shift is inevitable, thanks to our rapidly growing elderly population and the corresponding prevalence of chronic illness, along with the nationwide push for higher quality care at lower cost and dramatic advances in medical technology such as telemonitoring.

But let me tell you something I’ve learned as a physician who has spent the last five years on the front lines of home health care: Most primary care physicians have yet to adequately recognize, understand and appreciate the role that health care brought directly to the home can play. If my ongoing efforts to educate physicians about post-acute care has revealed anything, it’s that its basic function and overall value clinically and economically remain largely a well-kept secret.

Here then, in the interest of setting the record straight, are what I’ve identified as the six major myths about health care at home that tend to persist among physicians — versus the objective realities:

Myth: Health care at home offers no clinical advantages over a hospital, nursing home or assisted-living facility.

Reality: Health care at home can improve patient outcomes — mounting evidence suggests it can lower the risk of infection, promote adherence to follow-up appointments and ultimately enable patients to live longer, healthier, higher-quality lives.Effectively managing chronic diseases at home can prevent many of the complications that lead to costly emergency room visits and avoidable hospital admissions. Attention applied on a one-to-one basis via health care at home also yields rewards difficult to quantify. Services delivered compassionately empower patients to live with dignity. People receiving health care at home may eventually move better, eat better, breathe better, and suffer less pain.

Myth: Health care at home rarely saves on health care costs.

Reality: Health care at home can shorten hospital length of stay, lower readmissions, cut emergency-room visits and thereby cut overall health care costs, in some cases sharply. According to MedPAC and the U.S. Census Bureau, health care at home cost half as much as hospital care – even if the hospital stay averaged only five days and home health lasted 120 days. The hospital cost was $10,043, or $1,853 per day, compared to $5,706 for home health care, or $48 per day. With home health, in other words, per diem cost was more than 100 times lower.

Myth: Health care at home typically provides little more than a custodial service.

Reality: It’s actually a multi-dimensional, multi-disciplinary provider of superior post-acute clinical service. The health care professionals enlisted to serve should, and often do, get more directly involved in patient care than ever before.

Myth: Health care at home is generally well-coordinated with hospitals, with proper protocols in place. 

Reality: only about 20% of health care is actually integrated, by some estimates , while the rest remains fragmented,especially during and immediately after the crucial transition from hospital to home. Proper care calls for all the health care professionals involved — primary care physicians particularly, but also nurses, therapists and social workers — to be fully aware at any given time of which diagnoses are made, which tests administered, and which medications taken to collaborate efficiently. In the ideal scenario, the hospital physician contacts the post-acute physician who will be responsible for the patient, preferably in advance of discharge. Together, they discuss the case with an eye toward preventing recurrences. Hospitals form care-transition teams with a standard protocol for this handoff from institution to home.

Myth: Health care at home staff are generally unskilled aides. 

ADVERTISEMENT

Reality: highly trained clinicians, from nurses, nurse practitioners, physicians’ assistants, and physical therapists to pharmacists, speech therapists and social workers, are routinely deployed to home settings to do what they do, all the while serving as eyes and ears for the primary care physician.

Myth: Health care at home plays little or no part in driving down preventable hospital readmissions.

Reality: The number-one strategy that hospitals adopt to lower preventable readmissions is to partner with home health care agencies according to a survey conducted by HealthLeaders Media Intelligence Unit.

So there you go. The right partnership, with physicians and home health care operating side by side, will ensure that patients get the right level of post-acute care they need — at home. That’s more than good business. It’s also good medicine.

Michael Fleming, former president, American Academy of Family Physicians, is chief medical officer, Amedisys Home Health and Hospice.

Prev

Curbing prescription pain medication abuse by working together

September 18, 2014 Kevin 0
…
Next

Doctors need more quiet time

September 19, 2014 Kevin 44
…

Tagged as: Geriatrics, Primary Care

Post navigation

< Previous Post
Curbing prescription pain medication abuse by working together
Next Post >
Doctors need more quiet time

ADVERTISEMENT

More in Physician

  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Why don’t women in medicine support each other?

    Jessie Mahoney, MD
  • IMGs are the future of U.S. primary care

    Adam Brandon Bondoc, MD
  • The high cost of gender inequity in medicine

    Kolleen Dougherty, MD
  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why your clinic waiting room may affect patient outcomes

      Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT | Conditions
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy
    • Why U.S. universities should adopt a standard pre-med major [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

6 major myths about health care at home debunked
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...