Taressa K. Fraze (
Laura B. Beidler is a research coordinator at the Dartmouth Institute for Health Policy and Clinical Practice.
Health Aff (Millwood). 2019 Jun;38(6):1021-1027. doi: 10.1377/hlthaff.2019.00003.
Home visits are used for a variety of services and patient populations. We used national survey data from physician practices and accountable care organizations (ACOs), paired with qualitative interviews, to learn about home visiting programs. ACO practices were more likely to report using care transitions home visits than non-ACO practices were. Eighty percent of ACOs reported using home visits for some of their patients, with larger ACOs more commonly using home visits. Interviewed ACOs reported using home visits as part of care management and care transitions programs as well as to evaluate patients' home environments and identify needs. ACOs most often used nonphysician staff to conduct home visits. Home visit implementation for some types of patients can be challenging because of barriers related to reimbursement, staffing, and resources.
家庭访视用于各种服务和患者群体。我们使用来自医生诊所和问责制医疗组织(ACO)的全国调查数据,结合定性访谈,了解家庭访视计划。ACO 实践更有可能报告使用家庭访视进行护理转介,而非 ACO 实践则更倾向于使用家庭访视进行护理转介。80%的 ACO 报告为部分患者使用家庭访视,较大的 ACO 更常使用家庭访视。接受采访的 ACO 报告说,他们将家庭访视作为护理管理和护理转介计划的一部分,以及评估患者的家庭环境和确定需求。ACO 最常使用非医生人员进行家庭访视。由于与报销、人员配备和资源相关的障碍,某些类型患者的家庭访视实施可能具有挑战性。