The "New" House Call

House calls, once on the healthcare endangered list, have been making a comeback. But instead of a physician with a black bag, the visiting healthcare professional is more likely to be a nurse practitioner armed with a laptop computer.

“Nobody wants to be married to a doctor who works weekends and makes house calls at 2 am But every patient would like to find one.”—Ellen Goodman

House calls, once on the healthcare endangered list, have been making a comeback. But instead of a physician with a black bag, the visiting healthcare professional is more likely to be a nurse practitioner armed with a laptop computer.

One example of the new trend is Urban Medical, a Boston-based clinic that provides monthly house calls to 500 elderly, chronically ill patients. The program uses nurse practitioners who are connected by their computers to a team of healthcare professionals that includes doctors, hospitals, and a wide array of support services such as social workers and care coordinators.

Although house calls cost twice as much as an office visit, caring for the chronically ill in the home is much less costly than care in other venues like hospitals and nursing homes. According to a recent analysis, Urban Medical’s house call program cost 40% less than the cost of care for patients with similar conditions who did not get house calls. Most of the savings were achieved by preventing hospital admissions and deferring transfers to nursing homes.

$150Average cost for a physician house call. (Boston Globe, 2008)

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