Health Team

Study Finds House Calls a Hit and a Help for Seniors

The house call is not entirely history. A study reported in a national medical journal says that visits by PAs and social workers helped seniors.

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RALEIGH, N.C. — You may think that doctors making house calls is a thing of the past, but that’s not entirely true.

A new study looked at a variation on medical house calls for low-income seniors, and it found there were clear health benefits.

Myrle Ann Miller, who is 79, has greeted nurse practitioners at her home for two years now.

“That was much better than trying to go to the emergency room or trying to go to the clinic, and it makes it kind of hard for older people to do that,” Miller said.

A special health assessment and care program called GRACE is for low-income seniors. Researchers formed the program with social workers and nurse practitioners who are specially trained in geriatrics.

They visited patients – about 500 of them – in their homes.

The visitors are “especially focusing on things like vision and hearing, a medication review, screening for depression, looking at mobility and also doing a home safety check,” explained Dr. Steven Counsell of the Indiana University School of Medicine.

The team continued to visit their patients and talk to them by phone, with about 18 contacts with each patient each year over the two years.

The GRACE team members regularly consulted with each other and with doctors about the patients' needs. Their findings are published in the Journal of the American Medical Association.

“We showed that the GRACE program can reduce emergency department visits by over 20 percent and decrease hospitalization rates in the sickest group of patients by over 40 percent.” Counsell said.

Counsell said the general health and vitality of patients in the GRACE program was better than patients who received the usual care, and so was their social functioning and mental health.

The type of care GRACE provided is more expensive. It will take more research to see if the money saved in preventing emergency-room visits and hospital stays would be big enough to offset the cost.


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