Abstract
This chapter addresses the general approach to conducting a home-based medical encounter, clinical factors that are especially important to focus on in providing care for patients who cannot routinely leave their homes for office visits, and the basic equipment needed for home-based medical care. The medical equipment used in home-based medical care is essentially the same as that used in a typical office visit, and many ancillary services ordered in an office visit can also be performed in a patient’s home. Home-based medical care provides unique opportunities for the clinician to perform a comprehensive assessment of the patient, understand social determinants of health that impact the patient’s care, and integrate these factors into highly patient-centered care plans. This approach balances evidence-based medicine with patient prognosis, preferences, and ability to travel to a medical center for specialized testing or treatment. Similarly, preventive screening and health maintenance in the homebound population require an individualized approach that includes an understanding of prognosis, as well as disease and screening-test characteristics.
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References
Unwin BK, Jerant AF. The home visit. Am Fam Physician. 1999;60:1481–8.
Garcia-Alamino JM, Ward AM, Alonso-Coello P, et al. Self-monitoring and self-management of oral anticoagulation. Cochrane Database Syst Rev. 2010; 4: Art. No.: CD003839.
Matchar DB, Love SR, Jacobson AK, et al. The impact of frequency of patient self-testing of prothrombin time on time in target range within VA Cooperative Study #481: The Home INR Study (THINRS), a randomized, controlled trial. J Thromb Thrombolysis. 2015;40(1):17–25.
Tosteson AN et al. Consequences of false-positive screening mammograms. JAMA Intern Med. 2014;174(6):954–61.
United States Preventive Services Task Force. [Internet] Available from: http://www.uspreventiveservicestaskforce.org/
National Vital Statistics Reports. [Internet] Available from: http://www.cdc.gov/nchs/products/nvsr.htm
Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6.
Yourman LC et al. Prognostic indices for older adults: a systematic review. JAMA. 2012;307(2):182–92.
Fried LP et al. Risk factors for 5-year mortality in older adults: the cardiovascular health study. JAMA. 1998;279(8):585–92.
Larson EB et al. Survival after initial diagnosis of Alzheimer disease. Ann Intern Med. 2004;140(7):501–9.
Fried LP et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.
ePrognosis. [Internet] Feb 2015. Available from: http://eprognosis.ucsf.edu/default.php
Lee SJ et al. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. BMJ. 2013;346, e8441.
Tew WP et al. Breast and ovarian cancer in the older woman. J Clin Oncol. 2014;32(24):2553–61.
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© 2016 Springer International Publishing Switzerland
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Hayashi, J.L., Ripp, J., Colburn, J.L. (2016). How to Perform a House Call. In: Hayashi, J., Leff, B. (eds) Geriatric Home-Based Medical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-23365-9_4
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DOI: https://doi.org/10.1007/978-3-319-23365-9_4
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Publisher Name: Springer, Cham
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Online ISBN: 978-3-319-23365-9
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