Getting care to nursing-home patients: a problem and a proposal.

Data abstracted from transportation company records showed that nursing home patients made an average of 3.6 trips per year for care out of the nursing home. The bulk of this care (55 per cent) was provided at University Hospital with over a quarter provided at private physicians' offices and community health centers. On the basis of chart abstracts over half the patients had been seen within the previous month, but the quality of that visit was open to question. A means of providing cost-effective primary medical care in the nursing homes using a team of nurse practitioner and social worker is proposed.