title: Trends in physician house calls to Medicare beneficiaries.
abstract: OBJECTIVE
  House calls (HCs) to older adults seemed to be headed for extinction in recent decades. HCs may be a tool to ensure access and reduce institutionalization of the elderly population. This study determines the number and distribution of HCs by physician specialty over time and analyzes associations of providing HCs with physician and area-level characteristics.
  
  
  METHODS
  This study was a cross-sectional analysis of 3 complete Medicare Part B claims data for national state-representative samples of physicians in 2000, 2003, and 2006. Multilevel logistic regression determined associations between physician and area-level characteristics and provision of HCs in 2006.
  
  
  RESULTS
  Physicians made 478,088 HCs in 2000; 700,661 in 2003; and 995,294 in 2006. Over the same period, the proportion of physicians making HCs decreased from 7.22 (standard error, ±0.20) to 5.26 (±0.19). Physicians in the top decile of HC volume made an increasing number of HCs (median, 56 in 2000 and 86 in 2006). In 2006, physicians who made HCs were more likely to be older, geriatricians, and osteopaths, be in solo practice, and reside in rural areas compared with those who did not make HCs.
  
  
  CONCLUSIONS
  Between 2000 and 2006, the number of physician HCs to Medicare beneficiaries more than doubled, whereas the number of physicians making HCs declined.
authors.affiliation: The American Board of Family Medicine, Lexington, KY 40511-1247, USA. lpeterson@theabfm.org
authors.forename: Lars E
authors.initials: LE
authors.lastname: Peterson
authors.forename: Steven H
authors.initials: SH
authors.lastname: Landers
authors.forename: Andrew
authors.initials: A
authors.lastname: Bazemore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006299:Health Services for the Aged / Q000706:statistics & numerical data / Q000639:trends*; D006792:House Calls / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D019035:Rural Health Services / Q000706:statistics & numerical data / Q000639:trends; D014481:United States; D019037:Urban Health Services / Q000706:statistics & numerical data / Q000639:trends