Well, an exciting new report in JAMA about healthcare cost and how to reduce them in people who are a little bit older.
What some researchers did at the India University was they followed a group of patients, they followed them for over two years. Some of these patients were low income patients, in fact, most of them were low income patients. These are people who typically don’t get a lot of care. So what they did was they made home visits. I mean, you think that doctor’s house call is out of fashion but in some places, it actually still exists. They made an initial house call and then they followed up with these patients, and they monitored them on the phone and subsequent visits and they found that they decreased their rate of hospitalization by 40% and they decreased visits to the emergency room by 20% just by showing they care and by monitoring what these patients were doing at home.
Home health care can be really effective especially for the elderly who may have problems getting out of the house. The reason is because when somebody comes into the house, not only can they evaluate the person and the person’s body and the individual’s signs and symptoms, they can look at the environment. The reason this is so critical when we talk about elderly patients is because oftentimes, when you get older, you start to have problems with hearing, you start to have problems with your vision. And a lot of the home assessments that we do, they take into account things like throw rugs that perhaps somebody who is having decreased vision might stumble on or might trip on, are there stairs in the house, what can we do to mitigate some of the problems that somebody might have with that. And then also, some of things that we do with the elderly is we screen for depression, we check for mobility and other social functioning markers.
One of the problems as you get older is you tend—the chronic diseases that you have tend to get worse and then you tend to acquire problems with aging such as decreased vision, decreased hearing. You tend not to be able to move as swiftly or as rapidly, your reaction time is greater because your reflexes aren’t as quick as they used to be. So we tend to look at home health care visits as something that can really help in that because what we do is home assessments. And we take into account whether or not homes have stairs and whether we need to assist elderly patients in climbing those stairs because all you need is a fall and an elderly patient can break his/her hip and we know that 65% of patients who break their hips will die within two years of that fracture. So home assessments and home health care, it is very, very important to assess the home environment and that helps in turn reduce cost.
One of the important things to remember is for a lot of our elderly patients who are getting insurance to supplement their medicare insurance, make sure that insurance covers home health care visits. You never know when you may be too disabled to go to the doctor or maybe too cold outside that you want to call somebody and to come into your home and take the assessments and prescribe medication for you that way. You may want to have medication delivered. So it’s very important to have that component in your health insurance to make sure that the home healthcare peace is part of it so you can reduce the cost and optimize your healthcare.
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